How Much Does Concierge Medicine Cost? A Pricing Breakdown
Understand the real costs of concierge medicine in 2025: membership fees, what's included, how insurance works, and whether it's worth the investment.
How Much Does Concierge Medicine Cost?
One of the first questions patients ask when considering concierge medicine is: "What does it actually cost?" The answer varies significantly depending on the practice, location, and level of service. This guide breaks down the real costs, what your membership fee covers, and how to evaluate whether concierge medicine is a worthwhile investment for your health.
The Membership Fee: What to Expect
Concierge medicine membership fees — also called retainer fees — typically fall into three tiers:
Budget-Friendly Tier: $100 - $200 per month
Practices in this range often serve slightly larger panels (500-800 patients) and may not include as many premium features like house calls or executive physicals. However, they still offer dramatically better access than traditional primary care: longer appointments, same-day availability, and direct physician communication.
Annual cost: $1,200 - $2,400
Mid-Range Tier: $200 - $400 per month
This is where the majority of concierge practices fall. At this level, you typically get a physician with a panel of 300-500 patients, 30-45 minute standard appointments, comprehensive annual wellness exams, and direct phone or text access to your doctor. Many practices in this range include basic telemedicine visits and some after-hours availability.
Annual cost: $2,400 - $4,800
Premium Tier: $400 - $1,000+ per month
Premium concierge practices offer the most exclusive level of care. Panel sizes may be as low as 50-200 patients. These practices frequently include executive-level annual physicals (with advanced imaging, cardiac screening, and genetic testing), house calls, travel medicine consultations, and 24/7 physician availability. Some ultra-premium practices charge $25,000 or more per year.
Annual cost: $4,800 - $25,000+
What Does the Membership Fee Cover?
It is important to understand what the retainer fee does and does not include.
Typically Included in the Membership
- Enhanced access: Same-day or next-day appointments, direct phone/text/email with your physician
- Longer appointments: 30-60 minutes standard instead of 10-15
- Comprehensive annual wellness exam: Often more thorough than a standard physical
- Care coordination: Your physician coordinates referrals, follows up with specialists
- Telemedicine visits: Many practices include video visits at no extra charge
- Preventive care planning: Nutrition, exercise, sleep, and mental health guidance
Typically NOT Included in the Membership
- Lab work and imaging: These are usually billed to your insurance or paid out of pocket
- Specialist referrals: You will still need your insurance for specialist visits
- Prescriptions: Medication costs are not covered by the membership
- Hospital care: Inpatient stays are billed through your insurance
- Procedures: Surgical procedures, advanced diagnostics, and other specialized services
How Insurance Works with Concierge Medicine
A common misconception is that concierge medicine replaces health insurance. It does not. Here is how the two work together:
Your membership fee pays for enhanced access to your physician — the "concierge" layer. Think of it as a subscription for a better primary care experience. Your health insurance still covers the actual medical services: office visit charges, labs, imaging, specialist referrals, hospitalizations, prescriptions, and emergency care.Most concierge practices are "insurance-friendly" — they accept your insurance and bill it for covered services. You still pay copays and deductibles as you normally would. The membership fee is an additional expense on top of your insurance costs.
The HSA Question
Can you use a Health Savings Account (HSA) or Flexible Spending Account (FSA) to pay concierge membership fees? The answer is: it depends. The IRS considers some concierge fees as payment for medical care (potentially HSA-eligible) and others as payment for access (not HSA-eligible). The distinction often hinges on how the practice structures its fee. Consult your tax advisor for guidance specific to your situation.
Cost Comparison: Concierge vs. Traditional Care
To understand the true cost difference, let us compare a year of healthcare under both models for a typical patient.
Traditional Primary Care (Annual Costs)
| Item | Estimated Cost |
|---|---|
| Insurance premium (employee share) | $7,200 |
| 4 office visit copays ($30 each) | $120 |
| Urgent care visit (1x) | $150 |
| ER visit avoided? | N/A |
| Total out-of-pocket beyond premium | $270 |
Concierge Medicine (Annual Costs)
| Item | Estimated Cost |
|---|---|
| Insurance premium (employee share) | $7,200 |
| Concierge membership | $3,600 |
| Office visit copays (still billed to insurance) | $120 |
| Urgent care visits avoided (direct physician access) | $0 |
| ER visit avoided (physician phone triage) | -$1,500 savings |
| Total out-of-pocket beyond premium | $3,720 |
Is Concierge Medicine Worth It?
The value proposition depends on your individual circumstances. Consider these factors:
Strong Value For
- Patients with chronic conditions: If you need frequent physician contact, medication adjustments, and ongoing monitoring, the membership quickly pays for itself in avoided complications and better disease management.
- High earners who value time: If losing a half-day to sit in a waiting room represents a significant opportunity cost, guaranteed same-day appointments with minimal wait times deliver tangible value.
- Seniors managing multiple conditions: The care coordination aspect alone — having a physician who truly knows your full medical history and actively manages your specialist referrals — can prevent costly medical errors and hospital readmissions.
- Health-conscious individuals: If you want proactive, preventive care (advanced screenings, detailed wellness planning, lifestyle coaching), concierge medicine delivers this in a way traditional primary care cannot.
Weaker Value For
- Young, healthy individuals who rarely see a doctor and have no chronic conditions.
- Patients with tight budgets where the membership fee would create financial stress.
- People satisfied with their current care who have a good relationship with their existing physician and do not feel the need for enhanced access.
How to Evaluate a Practice's Pricing
When comparing concierge practices, ask these questions:
- What exactly is included in the membership fee? Get a detailed list. Some practices include annual physicals with advanced labs; others charge extra.
- Do you bill my insurance for office visits? Most do, but confirm. If they do not, your out-of-pocket costs will be higher.
- What is your panel size? A practice charging $300/month with 800 patients delivers less access than one charging $300/month with 300 patients.
- Are there additional fees? Some practices charge for house calls, after-hours access, or telemedicine visits on top of the membership.
- Is there a family discount? Many practices offer reduced rates for spouses or children.
- What is the cancellation policy? Understand whether you are locked into an annual contract or can cancel monthly.
Regional Price Variations
Concierge medicine costs vary by geography:
- Major metro areas (New York, San Francisco, Los Angeles, Boston): Expect higher fees, often $300-$600/month for mid-range practices.
- Mid-size cities (Nashville, Austin, Denver, Charlotte): Typical range of $200-$400/month.
- Smaller cities and suburbs: More affordable options, sometimes $100-$250/month.
- Rural areas: Fewer concierge options overall, but where available, fees tend to be lower.
Frequently Asked Questions
Can I negotiate the membership fee?
Some practices offer flexibility, especially for families enrolling multiple members. It never hurts to ask about family rates, annual payment discounts, or introductory pricing.
Do concierge doctors accept Medicare?
Some do, some do not. Concierge physicians who accept Medicare will bill Medicare for covered services and charge the membership fee separately. Others have opted out of Medicare entirely. If you are on Medicare, confirm the physician's Medicare participation status before enrolling.
What happens if I cannot afford to continue my membership?
Most practices have a cancellation process. You would transition back to traditional primary care. Some physicians will help with the transition by providing referrals and transferring your records. Be sure to understand the cancellation terms before signing up.
Are membership fees tax-deductible?
Potentially. If the concierge fee is structured as payment for medical services (rather than pure access), it may qualify as a deductible medical expense. Medical expenses that exceed 7.5% of your adjusted gross income are deductible if you itemize. Consult a tax professional for advice specific to your practice's fee structure.
How do concierge medicine costs compare to direct primary care?
DPC is typically less expensive: $50-$150/month compared to $200-$500/month for concierge medicine. DPC usually includes more services in the membership (basic labs, simple procedures) but does not bill insurance. Concierge medicine costs more but typically still involves insurance billing for covered services, and often provides a higher "access premium" (smaller panels, more exclusivity).