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How Concierge Medicine and Insurance Work Together

how does concierge medicine work with insurance

Key Takeaways:

  • Concierge medicine offers personalized healthcare with enhanced accessibility and a stronger doctor-patient relationship.
  • While membership fees for concierge medicine are typically not covered by insurance, many practices work with insurance for procedures, prescriptions, and other medical expenses.
  • Combining concierge medicine with a high-deductible health plan can offer comprehensive coverage, providing personalized care while maintaining insurance benefits for major medical expenses.

Concierge medicine is changing the game by offering personalized, on-demand healthcare. With longer appointments, same-day visits, and tailored care, it brings a level of attention traditional models often miss. But how does it fit with regular insurance? While many practices run independently, some partner with insurers, giving patients the best of both worlds.

If you’re curious about how concierge medicine could work for you, it’s important to understand how it can complement your existing insurance. At Mobile Care Health, we’re passionate about providing personalized care through our concierge telehealth services in over 34 states. We’d love to show you how our approach can transform your healthcare experience. Reach out and see how we can support your journey to better health.

What is concierge medicine?

Concierge medicine offers a personalized approach to healthcare, prioritizing your individual needs and providing enhanced access to your doctor. Let’s explore the key aspects of this innovative model:

  • Direct doctor-patient relationship: Enjoy longer appointments and direct communication with your physician, fostering a deeper understanding of your health concerns.
  • Enhanced accessibility: Benefit from prompt or next-day appointments, extended office hours, and direct phone or email access to your doctor.
  • Comprehensive care: Receive preventive services, wellness planning, and coordination of specialist care under one roof.
  • Focused patient care: Your doctor cares for fewer patients, allowing more time and attention for each individual.
  • Customized health plans: Work with your physician to create tailored strategies addressing your unique health goals and challenges.

The role of insurance in concierge medicine

Personalized healthcare models and traditional health insurance often function as distinct systems, but their interplay is becoming more nuanced. Many direct primary care practices operate independently from conventional insurance networks, prioritizing tailored care without the typical constraints of insurance-based approaches. 

Patients often invest in an annual membership, with fees ranging from $1,200 to $10,000, covering enhanced physician access and individualized attention. This approach allows doctors to dedicate more time to each patient, free from the administrative burdens often tied to insurance-based practices.

While membership fees typically aren’t covered by insurance, many personalized care practices still collaborate with insurance providers for certain services. Patients can often use their insurance for procedures, prescriptions, and other medical expenses included in their plans. 

This blended approach offers the best of both worlds. Imagine having a doctor who knows you by name, understands your health history, and can see you promptly when needed while still being able to use your insurance for specialized treatments or referrals. It’s like having a trusted health partner and a safety net.

Frequently asked questions

Can I use insurance to pay for concierge medicine services?

While concierge practices typically don’t accept insurance for membership fees, many work with insurance providers for other services. You’ll likely pay the membership fee directly, but don’t worry – your insurance may still cover procedures, prescriptions, and other medical expenses. 

What types of insurance work well with concierge medicine?

High-deductible health plans (HDHPs) often pair nicely with concierge medicine. These plans offer lower premiums for major medical expenses while your concierge membership takes care of your day-to-day health needs. Some PPO plans also work well, giving you more flexibility in choosing providers. Remember, your health journey is unique, and we’re committed to finding the perfect insurance concierge combination for you.

How do concierge doctors handle referrals to specialists?

We believe in personalized care, which also extends to specialist referrals. Your concierge doctor will tap into their network of trusted specialists, provide direct referrals, and even help coordinate your care. They’ll communicate with specialists on your behalf and help you understand your results. It’s like having a knowledgeable friend in the medical world who is always looking out for you.

Will my insurance cover lab tests and prescriptions ordered by a concierge physician?

In many cases, yes! While membership fees are separate, your insurance often applies to medical services like lab work, imaging, and prescriptions. Every plan is different, so we’ll help you check with your specific insurance to understand what’s covered. We aim to ensure you get the care you need without any surprises.

Are concierge medicine fees tax-deductible?

Concierge medicine fees could be tax-deductible as medical expenses. However, tax laws can be as complex as the human body! We always recommend chatting with a tax professional for advice tailored to your situation. They can help you navigate this aspect of your healthcare investment.

What should I consider when choosing insurance to complement a concierge practice?

Look for plans that give you flexibility in choosing providers and cover services your concierge practice doesn’t include. Consider your overall health needs, including any specific concerns you might have. For instance, if you’re worried about issues like black mold exposure, ensure your insurance covers related tests and treatments that your concierge practice might not provide

Can concierge practices offer services to people without insurance?

Absolutely! Many concierge practices welcome patients without traditional insurance. The comprehensive care concierge medicine provides can be a real lifeline for those without conventional coverage. However, we often suggest maintaining emergency health coverage for unexpected major medical events. Your peace of mind is important to us, and we’re happy to discuss options that provide both day-to-day care and a safety net for the unexpected.

Maximizing the synergy of concierge medicine and insurance

Harmonizing concierge medicine with traditional insurance creates a powerful synergy in your healthcare journey. To make this partnership work for you, consider pairing a high-deductible health plan for major medical expenses with a concierge membership for preventive care, wellness planning, and routine health management. 

Remember, open dialogue is your ally – don’t hesitate to discuss with your concierge doctor how they can collaborate with your insurance for lab tests and specialist referrals. This approach has shown remarkable results; take the Headache Center of Hope in Cincinnati, for example, where integrating fee-for-service options with membership plans has led to high patient satisfaction and improved health outcomes.

At Mobile Care Health, we’re proud to offer personalized telehealth services in over 34 states, designed to seamlessly complement your existing coverage. Our dedicated team is passionate about guiding you through the intricacies of combining concierge medicine with insurance, ensuring you receive comprehensive care that truly resonates with your needs. Why not reach out to us today? Let’s work together to craft a healthcare approach that meets your needs and exceeds your expectations, setting you on the path to lasting health and peace of mind.

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Clayton Evans

Clayton Evans is an IFA Certified Personal Trainer and IFA Certified Sports Nutritionist with over 5 years of experience in the health and fitness Industry. After years of struggling with his own health and fitness, Clayton lost over 30 lbs and started a career helping others achieve the best version of themselves. Clayton spent several years working with large corporate gyms developing fitness programs and working with Nutrition and Wellness Companies to improve a client’s overall health. His approach with clients is simple – small changes in fitness and diet that will have the largest impact and will fit into a client’s busy lifestyle.

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Brooke is a skilled and compassionate Adult Nurse Practitioner with over 10 years of experience in healthcare and a passion for helping patients achieve optimal health and wellness. Brooke holds a Master of Science in Nursing with a specialization in adult health and gerontology from Maryville University of St. Louis. She completed post-graduate training in functional medicine through the Institute for Functional Medicine and obtained her NP board certification through the American Academy of Nurse Practitioners Credentialing Board in 2019. As a Nurse Practitioner, Brooke seeks to address the root causes of disease and treat the whole person, rather than just the symptoms. She believes in taking a personalized and holistic approach to each patient. She has special interests in helping patients heal from metabolic syndrome, achieve their weight loss goals, optimize fertility, and recover from complex chronic illness. In her free time, Brooke enjoys hiking, reading, rollerblading, cooking healthy meals, and spending time with her fun-loving husband and spirited toddlers. She is excited to partner with you on your health journey and support you in achieving your goals.

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Kyle is a career Firefighter/Paramedic with extensive experience in the Denver metro area. He holds a bachelors of Health and Exercise Science from CSU. Kyle enjoys weightlifting, skiing, boating, and all the outdoor activities Colorado has to offer.

Jacqueline Carbone

Jacqueline Carbone is a highly experienced nurse practitioner that specializes in providing her clients with holistic, evidenced based, compassionate care. She specializes in Mental health, ketamine assisted therapy and Migraines. She is board certified from the American Nurses Credentialing Center. Jacque has her post Masters certificate from University of Colorado in Psychiatric Mental Health and two master’s degrees—one in acute care/geriatric nursing and one as a clinical specialist in geriatrics—from Georgetown University. She has also completed a fellowship with Dr Arnaldo DeSilva a headache specialist. She is passionate about providing a holistic treatment plan for her clients.

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Steve is a native of Colorado with bachelors in culinary nutrition. He worked as a classically trained chef, for over a decade. After chef life he shifted careers to join Mobile Care Health as our Operations Manager. Steve enjoys Crossfit, boating, road trips and camping.

Dr. Michael McGurren

Dr Michael McGurren was born and raised in Denver, Colorado. He graduated from Creighton University Medical School, and was the Chief Resident followed at Barnes-Jewish in St. Louis. He is board certified in Emergency Medicine and provides medical direction, as well as urgent care services for Mobile Care Health. In his free time he can be found sailing around the world, with a captains license and over 2500 nautical miles sailed. On shore he enjoys traveling with wife and pup Kylo in custom campervan.