You’re ready to take more control of your health. You want a doctor who knows your name, sees you quickly, and spends more than seven minutes with you.
Concierge medicine sounds like the right move — but one big question is holding you back:
How does this actually work with my health insurance?
If I’m paying a membership fee, what’s covered? What’s not? And what happens if I have Medicare?
At PartnerMD, we’ve helped thousands of patients navigate this exact situation over the last 20 years.
Whether they had private insurance, Medicare, or weren’t even sure what they had — we’ve walked them through how it works and what to expect, step-by-step.
In this article, you’ll get clear answers to the most common questions about concierge medicine and insurance, including:
How does concierge medicine medicine work with health insurance?
What's covered? What's not covered?
How does concierge medicine work with Medicare, Medicare Advantage, and Medicaid?
What does your membership fee actually pay for?
Let’s walk through what you need to know — starting with the big picture.
Yes, in most cases, you can use your health insurance at a concierge medicine practice just like you would at a traditional primary care office.
That means services like physicals, labs, and screenings are billed to your insurance — and any co-pays or deductibles apply just as they normally would.
But here’s the key distinction:
Your health insurance does not cover the concierge membership fee.
That’s because the fee isn’t considered a medical expense. It’s a monthly or annual payment for services outside of what insurance reimburses — like 24/7 physician access, longer appointments, and preventive care coordination.
At PartnerMD, we accept most major insurance plans and bill them as any primary care provider would. Your membership fee is an out-of-pocket expense — and it’s what allows us to deliver the level of service patients expect from concierge care.
While most concierge practices do work with insurance, there are some that market themselves as concierge but do not accept insurance at all.
These are typically what’s known as Direct Primary Care (DPC) practices. DPC is another alternative primary care model to traditional primary care. They can be similar, but often have a few key differences. Here’s how they differ:
DPC practices charge a monthly or annual fee — just like concierge medicine
But they do not bill or accept insurance for any services
Yes — concierge medicine can work with Medicare. But it depends on the practice.
At PartnerMD, we do bill Medicare for all eligible services, just like a traditional doctor’s office. That includes:
Annual wellness visits
Labs
Screenings
Other covered medical services
Your concierge membership fee, however, pays for:
24/7 access to your physician
Same-day or next-day appointments
Longer, more personalized visits
Ongoing preventive health planning
Support from your dedicated health coach
We’ve helped thousands of Medicare patients get more from their primary care without losing their existing benefits.
Medicare Advantage plans may be more limited. Always check whether your specific plan is accepted.
This is one area where concierge care typically isn’t an option. Most concierge practices, including PartnerMD, do not accept Medicaid.
If you have Medicaid, concierge medicine may not be the right fit — but we’ll always be honest about that and help you explore other solutions.
Your membership fee covers everything that insurance doesn’t — and everything that makes concierge medicine different.
Here’s what it includes at PartnerMD:
24/7 direct access to your physician
Extended appointments that last 30–60 minutes
Same-day or next-day scheduling
No waiting room delays
Direct communication by phone or email
A dedicated health coach focused on your wellness goals
Preventive planning that goes beyond insurance checkboxes
Over two decades, we’ve built a concierge care model focused on what patients value most: time, access, and a proactive relationship with their doctor.
We’ve all dealt with the frustration of navigating today’s healthcare system — long waits, rushed visits, and unclear billing.
Concierge medicine offers a more personalized approach, but understanding how it fits with your insurance is a critical part of evaluating whether it’s right for you.
Now that you know how insurance typically works with concierge care — what’s covered, what’s not, and how it compares to models like direct pay — you’re one step closer to making a smart, confident choice about your healthcare.
If you’re still exploring whether concierge medicine is the right fit overall, your next step is to read “What Is Concierge Medicine?” — it breaks down how the model works, who it’s for, and how it compares to traditional care so you can see the bigger picture.