Short answer: When your doctor switches to concierge medicine, you usually have three choices. You can pay the new fee and stay, you can find a different doctor, or you can ask for a copy of your records and decide later. Medicare does not pay the concierge membership fee, so ask what it costs before you decide.
Your doctor now asks patients to pay a membership fee, often called a retainer or concierge fee, on top of or instead of using insurance. The American College of Physicians (ACP), a medical society, says these fees are often tied to a promise of more personal and easier-to-reach care. Each practice sets its own terms, so the letter you received matters. Read it closely. You can also read about what concierge medicine is.
ACP recommends that doctors who reduce the number of patients they see help the patients who do not stay find other doctors. You can ask your doctor's office whether they will do that. You can also find a direct-pay doctor near you if you want to compare.
If you have Medicare, the rules matter. Medicare.gov says Medicare does not cover membership fees for concierge care, and you pay all costs for services Medicare does not cover, including the membership fee. It also says the fee depends on the contract or agreement you sign with the doctor or doctor group. Medicare.gov adds that doctors who accept assignment cannot charge you extra for Medicare-covered services. Ask the practice exactly which services the fee covers and how it bills Medicare for visits.
HHS says you generally have the right to look at your medical and billing records and get a copy from your health care providers. A provider cannot hold back your records because you have not paid for services. A provider may charge reasonable costs for copying and mailing, but cannot charge you for finding or pulling your records. Asking early helps if you move to a new doctor, because the new office can use them.
ACP has raised the concern that these practices may cause access problems for patients who cannot afford to pay directly for care. The group suggests doctors think about ways to lower barriers for lower-income patients. It is fair to ask the practice if it offers any help with the fee, and to ask what other options exist near you. If it is a health emergency, call 911.
No. Medicare.gov says Medicare does not cover membership fees for concierge care, and you pay that fee yourself.
HHS says you generally have the right to get a copy of your medical records, and a provider cannot hold them back because you have not paid for services.
ACP recommends that doctors who reduce their patient numbers help patients who do not stay find other doctors.
