Your doctor sends a letter announcing a concierge practice. To keep seeing the physician who knows your history, you will need to pay a membership fee. The letter describes longer appointments and easier access, then gives you a deadline to decide.
That puts a price on a relationship you already value. It also creates practical questions: what happens to your prescriptions, your next appointment, and the test results you are still waiting for if you leave?
Staying can make sense when you trust the doctor, can comfortably afford the fee, and will use the services the agreement promises. Finding someone new can make sense when the cost strains your budget, the offer leaves important questions unanswered, or another practice meets your needs.
Before you decide, get the terms in writing, compare available alternatives, and establish a plan for ongoing care.
First, Get the Dates and the Agreement
Ask the office for three dates: the enrollment deadline, the day the new membership starts, and the last day the doctor will provide your care under the existing arrangement. Ask whether your already scheduled appointments will still take place if you decline.
Then request the complete membership agreement and fee schedule. A brochure about personalized care does not tell you whether visits generate separate bills or whether leaving halfway through the year earns a refund.
The American Medical Association (AMA) says physicians should explain retainer terms clearly, disclose known implications for insurance, and ensure that patients choose the arrangement voluntarily. Its guidance also calls for transparent billing that separates membership amenities from medical services an insurer reimburses. 1
You can appreciate your doctor's reasons for changing the practice and still ask for time to compare your options.
Find Out What the Fee Changes
Start with the problems you want the membership to solve. Have you struggled to get appointments? Do you need more time to discuss several concerns? Does the office take too long to answer questions between visits?
Ask the practice to explain how the new arrangement addresses those specific problems.
What to clarify | Question to ask the office |
|---|---|
Your physician | Will I usually see my current doctor? Who covers absences? |
Appointment access | How do you handle same-day requests, and what happens when the schedule fills? |
Messages and calls | Who answers first, and what response times should I expect during and after office hours? |
Included care | Which visits, tests, procedures, and administrative services does the fee include? |
Separate bills | Which services will you bill to insurance or charge me for separately? |
Coordination | Who tracks specialist reports, pending results, and follow-up after hospital care? |
Leaving the practice | What are the minimum commitment, cancellation notice, renewal terms, and refund policy? |
Ask the office to show you where its answers appear in the agreement. If a service matters enough to influence your decision, it deserves a clear explanation.
A fee alone does not establish clinical quality. The AMA cautions physicians against implying that a retainer contract provides more or better medical services. Evaluate the access promises separately from your experience of the doctor's judgment, communication, and follow-through. 1
NextMD's guide to choosing a concierge or DPC doctor offers a broader framework for comparing practices. Direct primary care (DPC) is another membership model you may encounter during your search.
Compare the Full Annual Cost
Treat the membership as one line in your healthcare budget. Ask the practice and your insurer what happens to premiums, office-visit charges, deductibles, prescriptions, laboratory work, specialist care, and hospital bills.
For illustration, a $3,000 annual fee equals $250 per month. If two adults each need that membership, the household fee becomes $6,000 annually, or $500 per month, before any other healthcare expenses. These figures illustrate the arithmetic; they are not a quote from a particular practice.
Dividing the fee by expected visits can help you understand the expense, but it leaves out communication and coordination between appointments. Decide what those services are worth to you without assuming that they will produce medical savings.
Use this comparison for each option:
Annual membership + insurance premiums + expected charges outside the membership = estimated annual healthcare spending.
Ask about enrollment charges, family discounts, payment installments, and future increases. A monthly payment option can still carry a yearlong commitment. Read the cancellation terms before treating it as a monthly subscription.
If You Have Medicare
Medicare does not cover concierge membership fees. Doctors who accept assignment, meaning they accept Medicare's approved amount as full payment for covered services, cannot add extra charges for those covered services through the membership. Ask which noncovered services the fee purchases. 2
Also ask whether the physician will keep participating in Medicare. A doctor who opts out uses a different payment arrangement: Medicare generally will not pay for that doctor's services, apart from limited exceptions. Read any proposed private contract carefully. If you have Medicare Advantage, check the physician's participation and coverage rules with your specific plan. 3
Compare Your Doctor With Available Alternatives
Before paying primarily because you fear starting over, contact two or three other offices. Before declining because you expect an easy switch, confirm when another physician can actually see you.
Include an insurance-based primary care practice in your comparison. If you want membership care, also consider another concierge practice or a DPC practice.
The American Academy of Family Physicians describes DPC as a recurring payment for a defined set of primary care services, typically replacing insurance billing for that care. Patients still need to account for services outside the arrangement, including specialists and hospitalizations. 4
NextMD's concierge medicine versus DPC comparison explains the models in more detail. When interviewing offices, ask each one the same questions:
Are you accepting new patients, and when is the first appointment? Get a date rather than relying on a directory listing.
Who would be my regular physician? Confirm the doctor and how other clinicians participate in care.
Can the practice manage my ongoing needs? Describe your current conditions, medications, and specialist relationships. Ask whether any prescribing or monitoring falls outside its scope.
Does the physician participate in my exact insurance plan? Verify with both the office and insurer. Ask whether any membership fee applies.
How do patients get help between appointments? Ask about sick visits, refill requests, messages, and after-hours coverage.
How do you establish care with someone transferring from another doctor? Find out when records must arrive and whether the doctor needs an initial visit before assuming ongoing prescriptions.
An introductory conversation may help you assess fit. Ask whether the office offers one and whether it carries a charge.
Decide How Much Keeping This Doctor Matters to You
Consider what you would be preserving. Does the doctor listen, explain decisions, remember your preferences, and follow up reliably? Have you built trust through difficult medical decisions? Would the new arrangement give you useful access to someone you already know works well with you?
Those are reasons to consider staying. Familiarity deserves less weight if you routinely feel dismissed or leave visits without a clear plan.
Use these decision points:
Consider staying when the relationship works, the fee fits your budget, and the agreement addresses needs you can identify.
Consider switching when the fee would compete with necessary expenses, another practice fits your needs, or your dissatisfaction involves the physician rather than scheduling alone.
Resolve the uncertainty first when you lack written terms, have no confirmed alternative, or face a gap in ongoing care.
If you want to stay but cannot afford the quoted fee, ask whether the practice offers financial assistance, installment payments, or another physician who will continue insurance-based care. These are questions to ask, not benefits to assume.
If You Leave, Arrange the Handoff Before the Cutoff
Put names and dates against every outstanding care task. A records transfer does not tell you who will refill a medication next week or discuss a test result arriving after the conversion.
The AMA's ethics guidance calls for advance notice that allows patients to secure another physician and assistance with transferring care. Its retainer guidance also says that when transfer to another local physician is not feasible, the physician should continue care under the existing insurance arrangement until appropriate ongoing arrangements exist. These are professional ethics standards, not a universal legal notice period. 5 1
Confirm the New Appointment and Interim Care
Book the new-patient visit and tell your current office the date. If it falls after the cutoff, explain the gap promptly and request a specific interim plan. Ask the office to help identify an available physician if your search has stalled.
For each ongoing prescription, ask the current prescriber how to maintain treatment through the transition and whether an appointment or monitoring is necessary. Confirm what the new practice needs before taking over. Neither a records transfer nor an appointment booking guarantees a refill.
Request Records and Confirm Receipt
Request a copy for yourself and arrange delivery to the new practice through its accepted process. Include the medication list, allergies, diagnoses, recent visit notes, laboratory and imaging reports, specialist letters, vaccination history, and hospital discharge summaries where relevant.
Under the Health Insurance Portability and Accountability Act (HIPAA), patients generally have a right to access medical and billing records held by covered providers, subject to limited exceptions. The U.S. Department of Health and Human Services says a provider cannot deny a copy because the patient has unpaid medical bills. Permitted copying charges may still apply. 6
Ask the receiving office to confirm it has the records before your appointment. Downloading documents into your own portal account does not establish that the new physician received them.
Assign Responsibility for Unfinished Care
Make a short list of pending tests, referrals, medication renewals, and scheduled follow-ups. For each item, confirm which office will handle it and when you should expect an answer.
At the first visit, review that list alongside your medications and current care plan. NextMD's step-by-step guide to switching primary care practices provides additional transition planning.
A Message You Can Send Your Current Office
I am reviewing the concierge offer. Please send the full membership agreement, fee schedule, included services, insurance-billing policy, and cancellation terms. Please also confirm the enrollment deadline, membership start date, and final date for care under my current arrangement if I decline. I would like to know who will handle prescriptions, pending results, referrals, and records transfer during any transition. If I cannot find another physician before the cutoff, who should I contact to arrange interim care?
Frequently Asked Questions
Should I Pay to Keep My Current Doctor?
Consider paying when the relationship works well, the fee fits your budget, and the written benefits address your needs. Compare at least one available alternative before committing.
Will Insurance or Medicare Pay the Membership Fee?
Medicare does not cover concierge membership fees. For other coverage, request confirmation from your specific plan and ask the practice which services it will bill separately. 2
What If I Cannot Find Another Doctor Before the Deadline?
Tell the current practice promptly and request help arranging ongoing care. AMA ethics guidance addresses this situation and calls for continued care under the existing insurance arrangement when a local transfer is not feasible, until appropriate arrangements exist. 1
Can I Join for a Month While I Look Elsewhere?
Ask the office and read the contract. Monthly installments do not necessarily allow monthly cancellation, and the agreement may limit refunds.
Do I Lose Access to My Records If I Decline?
Declining membership does not erase your HIPAA access rights with a covered provider. Request your records and ask about the delivery process and any permitted copying fees. 6
You can search for concierge and DPC physicians on NextMD, compare practices near you, and use the questions above when you contact their offices. Confirm current availability, fees, and insurance arrangements directly with each practice.
Sources
American Medical Association. Retainer Practices. Code of Medical Ethics, Opinion 11.2.5. Read the retainer practice ethics guidance. Accessed September 23, 2026.
Centers for Medicare & Medicaid Services. Concierge Care. Medicare.gov. Read Medicare's concierge care coverage rules. Accessed September 23, 2026.
Centers for Medicare & Medicaid Services. Does Your Provider Accept Medicare as Full Payment? Medicare.gov. Read Medicare's provider participation and opt-out guidance. Accessed September 23, 2026.
American Academy of Family Physicians. (2024). Direct Primary Care. Policy adopted September 2024. Read the AAFP direct primary care policy. Accessed September 23, 2026.
American Medical Association. Terminating a Patient-Physician Relationship. Code of Medical Ethics, Opinion 1.1.5. Read the continuity and transfer-of-care guidance. Accessed September 23, 2026.
U.S. Department of Health and Human Services. (2025). Your Medical Records. Read the patient medical-records access guidance. Reviewed May 30, 2025; accessed September 23, 2026.