The membership fee for concierge medicine is never covered by insurance. That part is straightforward. What gets confusing is everything else: which services your plan will still pay for, how Medicare handles concierge practices, and whether your HSA can offset any of the cost.
This guide breaks down exactly what insurance covers and what it does not when you join a concierge practice, plus the questions to ask before you sign up.
How insurance works with concierge medicine
Health insurance covers standard medical services provided by a concierge doctor, but it never covers the extra monthly or annual membership fee. The two costs operate independently. Your insurance handles office visits, lab work, imaging, and prescriptions the same way it would at any traditional practice. The membership fee, on the other hand, comes directly out of your pocket.
So what exactly is concierge medicine? It is a membership-based healthcare model where you pay a retainer (typically annual or monthly) for enhanced access to your physician. In exchange, you get longer appointments, same-day scheduling, and often direct communication with your doctor by phone or text. The medical care itself remains billable to insurance when the practice participates in your plan.
Here is the basic breakdown:
- Membership fee: Paid directly to the practice for access, availability, and enhanced services. Never covered by insurance.
- Medical services: Billed to insurance the same way as traditional practices when the practice accepts your plan. Often covered.
What insurance does not cover in a concierge practice
Membership and retainer fees
No health insurance plan covers the annual or monthly membership fee. Medicare does not cover it. Medicaid does not cover it. Private insurance does not cover it. The IRS and insurance carriers classify the fee as payment for access and availability rather than for specific medical treatment. You might pay anywhere from $1,500 to $25,000 per year depending on the practice, and that entire amount is your responsibility.
Direct physician access and communication
The ability to text, call, or video chat with your physician at any hour is an amenity included in your membership. Insurance does not reimburse for this access because it is not a billable medical service. You are paying for the relationship and the convenience, not for a procedure or diagnosis code.
House calls and concierge amenities
Home visits, hotel or production-set appointments, travel medicine coordination, and private waiting areas fall outside what insurance considers covered care. If your concierge physician comes to your home or meets you at a film set, that convenience is part of your membership fee, not something you can submit to your insurance.
What insurance still covers when you see a concierge doctor
| Service Type |
Insurance Coverage |
|
Annual physical exam |
Typically covered |
| Lab work and blood tests |
Typically covered |
| Imaging (X-ray, MRI) |
Typically covered |
| Specialist referrals |
Typically covered |
| Membership fee |
Never covered |
| 24/7 physician access |
Never covered |
Office visits and preventive care
Standard office visits, wellness exams, and preventive screenings are billed to your insurance just as they would be at any physician’s office. Your copays, deductibles, and coinsurance still apply. The concierge model changes how you access your doctor, not how insurance processes claims for covered services.
Labs, imaging, and diagnostics
When your concierge physician orders blood work, an MRI, or other diagnostic tests, the orders go through your insurance like any other medical referral. The lab or imaging center bills your plan directly. Your membership fee has no bearing on how insurance handles diagnostic services.
Specialist referrals and hospital care
Referrals to specialists, hospital admissions, and surgeries remain within the insurance system. Your concierge physician coordinates your care and communicates with specialists, but insurance continues to cover services according to your plan’s terms. The membership gives you a more attentive primary care relationship; it does not replace your coverage for major medical events.
What the concierge membership fee pays for
Since insurance will not reimburse the membership fee, understanding what you receive in return helps you evaluate whether the investment fits your life.
Same-day and extended appointments
Most concierge practices limit their patient panels to a few hundred members rather than the thousands a traditional primary care physician might carry. A smaller panel allows same-day appointments and visits that last 30 to 60 minutes instead of the typical 10 to 15. You spend more time with your doctor, and your doctor spends more time thinking about your case.
Twenty-four-seven access by call, text, and video
You communicate directly with your physician, not an answering service. For patients who travel frequently or live across time zones, this access can mean reaching your doctor from a hotel room in Dubai or a film set in Vancouver. The membership fee pays for that availability.
Personalized care planning and coordination
Your physician conducts a baseline health assessment and builds an ongoing care plan tailored to your goals. At Beverly Hills Spine & Joint, this includes coordination for international patients traveling from Saudi Arabia, Qatar, and the GCC who require telemedicine follow-ups and travel-medicine planning. The membership fee covers the time your physician spends coordinating your care across specialists and locations.
Treating the whole body is solely dependent upon having an intimate understanding of each of its individual parts. Mechanical dysfunction of non-traumatic origin is practically certain to cause — or be caused by — dysfunction in another region.
— Dr. Amin JavidWhy some concierge practices do not accept insurance
Not all concierge practices operate the same way. The two main models differ in how they handle insurance:
- Hybrid model: The practice accepts insurance for covered medical services, and the membership fee is separate. You pay the retainer for access, and your insurance handles the clinical care.
- Direct primary care model: The practice does not bill insurance at all. You pay the membership fee plus per-service fees for everything, including office visits and basic procedures.
Before joining any concierge practice, ask which model they use. The answer determines whether your insurance will offset any of your medical costs or whether you are paying entirely out of pocket.
Does Medicare cover concierge medicine
Medicare does not cover the membership fee under any circumstance. However, if the concierge practice accepts Medicare assignment, Medicare will cover standard medical services like office visits, preventive care, and diagnostic tests. According to Medicare.gov, Medicare-covered services depend on whether the doctor accepts Medicare, not on whether the practice operates as concierge.
Here is the catch: some concierge practices opt out of Medicare entirely. If you have Medicare, verify before joining whether the practice participates. Otherwise, you may pay the membership fee and still face full out-of-pocket costs for every visit.
Can you use an HSA or FSA to pay concierge fees
IRS rules currently do not allow HSA or FSA funds for concierge membership fees. The fee covers access and availability rather than specific medical treatment, so it does not qualify as a deductible medical expense.
Individual medical services billed separately may qualify if they meet IRS criteria. For example, if your concierge physician orders lab work and you pay out of pocket, that expense might be HSA-eligible. The retainer itself, however, is not.
Is the concierge membership fee tax deductible
The membership fee is generally not tax-deductible as a medical expense because it pays for access rather than treatment. Some patients attempt to deduct it as part of their total medical expenses, but the IRS has not issued clear guidance supporting this approach. A tax professional can advise on your specific situation.
Insurance and international or cross-border concierge care
U.S. health insurance typically does not cover care received abroad. If you travel frequently or split time between countries, your domestic plan may not apply when you are outside the United States.
Travel insurance or international health plans may fill this gap. Telemedicine follow-ups with a U.S. concierge physician may or may not be covered depending on your plan’s telehealth provisions and your location at the time of the visit.
Beverly Hills Spine & Joint coordinates care for international patients traveling from Saudi Arabia, Qatar, and the GCC. This includes telemedicine follow-ups and travel-medicine planning that work around time zones and travel schedules, all covered under the membership.
Questions to ask a concierge practice before you join
What is included in the membership fee
Ask for a clear list of services covered by the fee versus services billed to insurance. Some practices include annual physicals and basic labs in the membership; others bill everything separately. The answer affects your total cost.
Which insurance plans the practice bills
Confirm whether the practice is in-network or out-of-network for your specific plan. Out-of-network billing can mean higher out-of-pocket costs even when services are technically covered.
How Medicare and out-of-network coverage are handled
If you have Medicare or a plan with limited out-of-network benefits, ask how the practice handles reimbursement. Some practices submit claims on your behalf; others require you to file for reimbursement yourself.
Choosing concierge care that fits your coverage and your life
Concierge medicine and health insurance work together rather than replacing each other. You keep your insurance for hospitalizations, specialists, and emergencies while gaining direct access and personalized attention through the membership.
The Beverly Hills Spine & Joint Concierge Medicine Membership offers 24/7 direct access to Dr. Amin Javid, D.C., same-day appointments, house calls at home, office, hotel, or production set, and telemedicine from any time zone. Enrollment is limited to 20–30 members to preserve the quality of the physician relationship.
Know more about Beverly Hills Concierge Medicine Membership
Frequently asked questions about concierge medicine and insurance
Do you still need health insurance if you have a concierge doctor?
Yes. A concierge membership covers access to your primary physician but does not replace health insurance for hospitalizations, surgeries, specialist care, or catastrophic events. You maintain your insurance for everything beyond primary care.
Can a concierge doctor bill Medicare for covered medical services?
If the concierge practice accepts Medicare, the physician can bill Medicare for covered services like office visits and preventive care. The membership fee remains a separate, out-of-pocket cost that Medicare will not reimburse.
Does a concierge membership count as health insurance under the ACA?
No. A concierge membership does not satisfy the Affordable Care Act’s minimum essential coverage requirement. You still need a separate qualifying health insurance plan to meet ACA standards.
What happens to your health insurance if you cancel a concierge membership?
Canceling a concierge membership has no effect on your health insurance. Your insurance coverage continues independently, and you can return to a traditional primary care practice at any time without penalty.
Dr. Amin Javid, D.C. is a State and National Board Certified Chiropractic Physician who leads Beverly Hills Spine & Joint. He completed the Yale University Medical School affiliate rotation at the New Haven VA Hospital and publishes peer-reviewed research on human biomechanics indexed on PubMed Central (PMC11483166). He received the American Chiropractic Association Sports Council Award and earned recognition as a Top Chiropractor by Los Angeles Magazine. His work has been featured in Vogue, Women's Health, and CNN. He is also the physician who formulated Leniva Pain-Relief Balm — an FDA OTC Registered Drug with four active ingredients and 23 botanical extracts.