A concierge membership is a commitment to a relationship with a particular doctor and practice, usually for a year at a time. Practices differ a great deal in what the fee includes and how access actually works day to day, so the best memberships are the ones you understand fully before you sign.
The American Medical Association's ethics opinion on retainer practices expects practices to present their contract terms honestly and without pressure, and says a membership should not be promoted as a promise of better diagnostic or treatment services. A good practice will welcome the questions below. We would rather you ask them of us than join and be surprised.
Questions About What the Fee Covers
What exactly does the membership include?
Ask for the list in writing. Common elements are longer visits, same-day or next-day appointments, direct phone or text access to the doctor, an extended annual physical, and help coordinating specialists. Find out which of those are guaranteed and which are "when available."
Does the practice still bill my insurance or Medicare?
This matters more than the fee itself. Many concierge practices bill insurance and Medicare for covered visits, labs, and tests in addition to the membership, so you keep your coverage for those services. Our article on whether Medicare covers concierge medicine explains how that works.
Has the doctor opted out of Medicare?
Ask this directly if you have Medicare. A doctor who has opted out of Medicare signs private contracts with patients, and according to Medicare.gov, Medicare will not pay for any service you receive from that doctor, even one Medicare normally covers. That is a very different arrangement from a Medicare-participating concierge practice.
What costs are not included?
Specialist visits, hospital care, imaging, and most prescriptions are usually billed separately. Ask about in-office labs too. The difference between concierge medicine and direct primary care often shows up here.
Questions About Access
How quickly can I be seen when I am sick?
"Same-day access" can mean a visit, a phone call, or a message back by the end of the day. Ask what a typical sick visit looks like, how appointments are booked, and whether telehealth visits are included.
How do I reach the doctor after hours?
Ask whether you reach your own doctor, a covering physician, or an answering service, and what happens on weekends and holidays.
Who covers when my doctor is away?
Every doctor takes vacations and attends conferences. Ask who sees members during those times and whether that clinician has access to your chart.
How many members does each doctor care for?
Smaller panels are what make the extra time possible. A practice does not have to share an exact number, but it should be able to describe how it keeps the panel limited.
Questions About the Doctor and the Practice
What happens if I am hospitalized?
Some concierge doctors visit members in the hospital; many coordinate with the hospital team and see you promptly afterward. Ask which, and how records are shared. Our article on the follow-up visit after a hospital stay explains why that first week matters.
How will you manage my chronic conditions?
If you live with high blood pressure, diabetes, or several specialists, ask how the practice handles monitoring between visits and who coordinates the specialists.
What happens if my doctor leaves or retires?
Ask whether the membership continues with another physician, is refunded, or ends. The AMA expects doctors to help transfer care when a patient leaves a membership practice, and a well-run practice will have a plan.
Questions About the Fine Print
- How is the fee billed: annually, quarterly, or monthly?
- Is there a waitlist, and does joining lock in my spot?
- Can I cancel, and is any part of the fee refundable if I move or my health changes?
- Can a spouse or partner join, and on what terms?
- Can the practice provide an itemized statement of what the fee covers for my records or benefit plan?
Questions to Ask Yourself
The practice's answers are only half of the picture. The other half is how you actually use health care, and a few honest questions help:
- How many times did I see a doctor last year, and how often did I wait longer than I wanted to get in?
- Do I manage several chronic conditions or see several specialists who need coordinating?
- How much would direct phone or text access to my doctor change things for me or my family?
- Do I travel or spend part of the year away, and would remote access help while I am gone?
- Would I rather put the membership fee toward other health costs, such as dental, vision, or a gym?
There are no right answers here. Some people who rarely see a doctor still value a membership for peace of mind, especially as they get older or care for a spouse. Others find that a traditional practice with good same-week access meets their needs. The point is to decide deliberately rather than because a letter arrived with a deadline.
Making the Decision
Once you have the answers, compare them with how you actually use health care. Our honest look at who benefits most from concierge medicine can help you weigh it, and concierge versus traditional primary care lays out the tradeoffs side by side.
Zimmer Medical Group offers a limited concierge membership in St. Petersburg alongside traditional primary care. Call (727) 820-7800 to ask us any of these questions. Membership details are discussed by phone.
