"Concierge medicine" is a label that means wildly different things in different practices. Some practices charge $800 a year for slightly shorter waits. Others charge $25,000 for a doctor who flies with you. When someone says they're in concierge medicine, that's a range, not a definition.
Here's how the tiers actually work, what each costs, and what I'd ask before joining any of them.
What concierge medicine is, in general
Concierge medicine is a model where you pay your physician directly for access and time. The common thread: smaller patient panels than traditional primary care, longer visits, and some form of after-hours reach. Beyond that, the specifics vary a lot.
Traditional primary care doctors typically carry 2,000 to 3,000 patients and see them in 7 to 15 minute slots. Concierge practices usually cut panel size to somewhere between 300 and 600, run 30 to 60 minute visits, and offer same- or next-day access for urgent issues.
| Traditional | Concierge | |
|---|---|---|
| Panel size | 2,000 to 3,000 | 300 to 600 (mine: 50) |
| Appointment length | 7 to 15 min | 30 to 60 min |
| Wait for appointment | Days to weeks | Same or next day |
| After-hours access | Office hours only | Varies by practice |
| House calls | Rarely | Often included |
The three common tiers
Full-scale concierge
The most hands-on version. Panels typically 300 to 400 (mine is 50). House calls included. Direct cell phone to the physician. Travel medicine, coordination of all specialist care, personalized wellness programs. This is what most people picture when they hear "concierge medicine." It's also the most expensive, usually $5,000 to $25,000 or more per year.
This tier is where the doctor can actually function as your first-line resource around the clock. If that's what you're looking for, ask what the physician's panel actually is, whether the cell phone number goes to the doctor or a service, and what the billing model is (is it private-pay, or does the practice still bill insurance?).
Partial concierge
Larger panel than full-scale, more limited access. You still get extended visits and faster appointments, but probably not 2 a.m. cell phone access. House calls are less common. Specialist coordination exists but may not be as tight.
Typical range: $1,500 to $5,000 a year. This can be a reasonable middle ground for people whose needs aren't especially complex.
Concierge lite
A loose category that varies a lot by practice. Some same-day appointments, slightly longer visits, limited direct physician access. House calls usually aren't included. No guarantee you'll reach the same physician when you call.
Typical range: $500 to $1,500 a year. It's a step up from traditional primary care but shouldn't be confused with full-scale concierge.
How to actually evaluate a practice
When you look at concierge practices, the marketing will usually sound similar. The questions that tell them apart:
- What is the physician's actual panel size today?
- When I call after hours, who answers, and how fast?
- What's in the membership fee and what gets billed separately?
- Is the practice private-pay, or does it also bill insurance?
- Are house calls standard, or an extra?
- If I'm admitted to the hospital, what does the physician do?
A physician who's comfortable with how they practice will answer these directly.
Questions I get asked
Does insurance cover concierge medicine?
The membership fee isn't covered by insurance. Some concierge practices still bill insurance for the medical services they provide, so you're only paying the membership for the access and time. In my practice, nothing is billed to insurance; it's private-pay. You keep insurance for everything that happens outside my office (labs, imaging, specialists, hospital care, prescriptions).
Is concierge medicine only for wealthy people?
Full-scale concierge is expensive. Partial and lite tiers make the model accessible to more people. Whether it's a good use of money depends on your situation, not your income. If you have complex health needs, a demanding schedule, aging parents, or a pattern of expensive ER visits, the math can work in your favor. If you're healthy with simple needs, a direct primary care practice or a traditional plan may be a better fit.
What about specialists?
Good concierge physicians coordinate specialist care. Professional networks usually mean faster referrals than a cold call, and the physician stays involved so handoffs don't drop things. That coordination is one of the real benefits of the model.
Where my practice fits
My practice is full-scale concierge, on the smaller-panel end of that tier. I cap at 50 patients. I give patients my cell phone. Text or call any hour and you reach me directly. Same-day visits, including house calls across Palm Beach County. Private-pay; I don't bill insurance.
If you want to talk through whether concierge medicine makes sense for you, at any tier, reach out. I'll tell you directly whether I think my practice is the right fit or whether a different model serves you better.
