topic Re: Anyone have Conceirge Medicine Coverage? in Wellness

Anyone have Conceirge Medicine Coverage?

Witchy Woman — Wed, 02 Jul 2025 12:51:04 GMT

I know it is expensive, but just curious if anyone has it and how it has worked for them.

Thanks in andvance.

Re: Anyone have Conceirge Medicine Coverage?

Still Raining — Wed, 02 Jul 2025 12:55:37 GMT

Please ask about your insurance being covered and billed. Would also be good to understand what your plan will not pay for. Some practices have restrictions.

Re: Anyone have Conceirge Medicine Coverage?

Witchy Woman — Wed, 02 Jul 2025 12:59:17 GMT

@Still Raining

Thanks. I know this.

I'm still interested in anyone's experience with this type of coverage.

Re: Anyone have Conceirge Medicine Coverage?

kaydee50 — Wed, 02 Jul 2025 13:08:25 GMT

Years ago the PCP that I was seeing opened her "concierge" office. She sent me a letter explaining the benefits and costs.

If I had serious, chronic healthcare concerns, e.g, diabetes, heart disease, etc. and needed to see a doctor quickly, I might consider it.

Otherwise, see no need for it.

Re: Anyone have Conceirge Medicine Coverage?

Snowpuppy — Wed, 02 Jul 2025 15:52:54 GMT

My PCP is now semi retired and has a colleague practicing concierge medicine.

He posts monthly or annual costs, provides early am/after hours pm in person or telehealth visits.

Neither my PCP nor the concierge medicine doctor accepts insurance up front. You pay first, then you fight with your own insurance company and wait for reimbursement.

Re: Anyone have Conceirge Medicine Coverage?

Witchy Woman — Wed, 02 Jul 2025 16:41:36 GMT

@Snowpuppy

I'm operating on the assumption that most insurance will NOT pay anything towards such coverage.

Like so many things, this seems to be an area of you won't know until you try it...and it costs a lot to try.

I have Medicare and good health insurance, so I'm lucky I can afford those things without struggling. I know that is not the case for everyone.

Re: Anyone have Conceirge Medicine Coverage?

Mz iMac — Wed, 02 Jul 2025 17:10:14 GMT

@Witchy Woman wrote:

I have Medicare and good health insurance, so I'm lucky I can afford those things without struggling. I know that is not the case for everyone.

@Witchy Woman Does that mean you read your policy & confirmed you are not covered for medical Conceirge services?

Mine does sort of. My insurance will pay for Conceirge "NURSING" services only. An RN is at my beck & call to make house calls if needed 24/7/365 days a year. He or She also does Zoom calls if you have any medical questions.

I am not sickly so not needed **at this time.**

Re: Anyone have Conceirge Medicine Coverage?

Witchy Woman — Wed, 02 Jul 2025 17:18:30 GMT

@Mz iMac

No, I have not fully reviewed my secondary coverage (a Federal employee health plan), to see if they have concierge nursing coverage. I'll have to check and/or call to ask.

Medicare is the primary coverage and my Federal plan is secondary. I'm assuming neither covers such speciality care, but I have not confirmed that in any way.

Re: Anyone have Conceirge Medicine Coverage?

Carmie — Wed, 02 Jul 2025 17:18:57 GMT

I don't have it and I'm not interested in getting it.

I don't think it is bad for some people, but for many it is not a good choice.

If you only ever see one doctor for everything and see that doctor often, it might be fine, after you you are paying a great price for boutique health care.

If you see multiple doctors for different problems, a GYN, a Cardiologist,Ophthalmologist, an orthopedic doctor, a mental health provider, dermatologist, physical therapist, gastro doctor, ambulance company, etc. you would be wasting your money away.

Most people as they get older see a variety of different speciality doctors and prefer them to be in the same network. That way health care can be coordinated and all providers have access to all of your health records and tests results.

Mammograms and colonoscopies require a speciality doctor as well as radiologists who read x rays and dexa scans.

If you pay for concierge care upfront and very seldom use it, you would still be responsible for deductibles and coinsurances from your health care from your health care company for services preformed by others.

It is also a PIA to get paperwork for claims to file with your insurance company.

For me it would be a waste of money. It's way too expensive and wouldn't meet my needs.

Re: Anyone have Conceirge Medicine Coverage?

Mz iMac — Wed, 02 Jul 2025 17:31:19 GMT

@Witchy Woman I am also a retired Federal employee. I have an Advantage Plan which is bundled w/FED Health Plan I believe.

Re: Anyone have Conceirge Medicine Coverage?

msgb — Wed, 02 Jul 2025 18:54:59 GMT

The last GP my husband saw is now concierge. My husband had to opt out. It is pricey.

Re: Anyone have Conceirge Medicine Coverage?

Witchy Woman — Wed, 02 Jul 2025 20:02:50 GMT

@Mz iMac

I have GEHA, Government Employees Health Association and have been enrolled for over 40 years. It was the plan I used when employed in Washington, DC, at a Federal agency and took it with me into retirement.

After doing some checking, I determined it was as good or better as any secondary insurance I could purchase outside of the Federal network.

With Medicare and GEHA, I rarely have any health care bills...thankfully.

Re: Anyone have Conceirge Medicine Coverage?

Witchy Woman — Wed, 02 Jul 2025 20:04:00 GMT

@Carmie

All good points.

Thanks for your thoughtful response.

Re: Anyone have Conceirge Medicine Coverage?

granddi — Wed, 02 Jul 2025 21:35:24 GMT

@Witchy Woman I was watching the replies because I am also intersted.

I think the question is NOT if the forum thinks it is a good idea but rather asking if anyone has experiences.

Conceirge is basically private pay health care. My clinic has a conceirge office within the regular care doctors. I have tried to get someone to answer if I could have a hybrid of both. The conceirge would/should eliminate the use of walk in clinics and long wait times for a PA.

Re: Anyone have Conceirge Medicine Coverage?

I am still oxox — Wed, 02 Jul 2025 21:42:37 GMT

My brother does and he is very happy with the care he gets last year when he had lyme, he sent them a photo of the rash and had a telemed conference in about 20 minutes. He works in Manhattan and they have an office very close to his office. He says they are very prompt and rarely has a wait

Re: Anyone have Conceirge Medicine Coverage?

Bookplate — Wed, 02 Jul 2025 22:25:37 GMT

I don't have it but a good friend does. Last year she paid something over $1000, out of pocket, for the service. When she does see the doctor, it is covered by Medicare and supplemental, like any other visit. There were a few occasions this past year when she wanted to be seen by a doctor quickly, and she was. So far she has been satisfied. I should add that she is in her mid-80's with some serious, but not critical, health issues.

Re: Anyone have Conceirge Medicine Coverage?

Witchy Woman — Wed, 02 Jul 2025 23:38:33 GMT

@granddi

Yes, that was my question. I know to some it might be a waste of money, and it might very well be for them.

However, while I'm mostly happy with my doctors, short notice appointments are difficult/impossible to get. In this area, "urgent care" is a joke. You can wait hours and will likely end up will little or no care. The emergency rooms are often full all day long.

As I age, I'm just trying to make the best decisions I can for the kind of care I would LIKE to receive.

Re: Anyone have Conceirge Medicine Coverage?

Witchy Woman — Wed, 02 Jul 2025 23:45:18 GMT

@I am still oxox

Sounds ideal. I'm sure being in Manhattan helps.

I live in the Washington, DC, area, but over an hour outside the City in a small, rural community.

Part of the problem for me is I hate to drive into the city for ANY reason!

Re: Anyone have Conceirge Medicine Coverage?

Witchy Woman — Wed, 02 Jul 2025 23:48:15 GMT

@Bookplate

That cost does not seem unreasonable to me.

It sounds like it's a good fit for your friend. Seeing someone quickly is a key advantage.

Sadly, most medical appointments are scheduled weeks/months out and getting worse.

Re: Anyone have Conceirge Medicine Coverage?

River Song — Thu, 03 Jul 2025 13:58:09 GMT

I don't have concierge medical coverage, can't afford it. I live in a Florida resort town with tons of multimillionaires and a few billionaires (not me, though). A lot of doctors in my town have switched to concierge medicine because it's lucrative, decreases their workload, no insurance companies to deal with, and they can spend more time with the patient. Wealthy people want what they want, when they want it and are willing and able to pay for it. Wish I could have my doctor at my beck and call but that's never going to happen for me. If you can afford the yearly membership fee, it's probably worth it to receive luxury care. Membership fees in my area run $2,000-$5,000/year with some running $10,000/year.