How Medicare and concierge medicine fit together, what the membership fee pays for, and the questions to ask any practice before you join.
If you are on Medicare and thinking about concierge medicine, the first question is usually about money: will Medicare pay for it? The short answer is that Medicare and a concierge membership pay for different things. Understanding the difference makes it much easier to decide.
In brief
- Medicare generally does not pay the concierge membership fee.
- Covered medical care can still be billed to Medicare when the practice accepts it.
- Ask any practice whether it takes Medicare and exactly what the fee includes.
The short answer
Medicare generally does not pay a concierge membership fee. That fee is for extra services, like same-day access and being able to call your doctor directly, that Medicare does not cover. The medical care itself, such as visits, tests and treatment that Medicare normally covers, can still be billed to Medicare when the practice accepts it.
What the membership fee pays for
A concierge membership pays for the parts of care that insurance does not. These usually include:
- A smaller patient list, so your doctor has more time for you
- Same-day or next-day appointments
- Calling or texting your doctor directly, including after hours
- Longer, unhurried visits
- Help coordinating specialists, records and paperwork
What Medicare still pays for
When a concierge practice accepts Medicare, covered medical services are billed to Medicare just like at any doctor’s office. That can include office visits, lab work and imaging, depending on your coverage. Your usual deductibles and copays still apply. If you have a Medicare Advantage plan or a supplement, check how your plan handles the practice.
Have questions about Medicare and membership?
We accept Medicare and most insurance plans. Book a free consultation and we can talk through how it works for you.
Questions to ask any concierge practice
- Do you accept Medicare? Some concierge practices accept it and some do not. This makes a big difference to your total cost.
- What exactly does the membership include? Ask for the list in writing.
- How is the fee billed? Monthly, every 6 months or yearly.
- How do I reach the doctor after hours? Ask whether you reach your own doctor or an answering service.
- What tests can be done in the office? On-site labs and imaging save trips.
- Do you make house calls? Helpful if getting out is hard.
- Which hospital do you work with?
Is it worth it on Medicare?
Many people on Medicare choose concierge care because they see doctors more often and want things to be simpler: one doctor who knows their whole history, quick answers, and help keeping specialists and medications organized. Adult children often like it for a parent, because with permission they can be kept informed and included.
How it works at Wave Concierge
Wave Concierge in Boynton Beach accepts Medicare and most insurance plans. Covered medical care is billed to Medicare or your insurance, and the membership fee is separate and covers the concierge service.
- Concierge plan: $2,500 per member, billed every 6 months
- Executive plan: $7,500 per member, billed every 6 months, and adds house calls when needed
Members can call, text or video their doctor 24/7. Labs, X-ray, ultrasound and MRI are in our building, and when a hospital stay is needed, members are admitted directly to Delray Medical Center when possible, skipping the ER. Compare the plans or read our FAQ.
See it before you decide
Book a free tour and consultation at our Boynton Beach office. Bring your Medicare card and your questions. No obligation to join.
This article is general information, not medical advice for your situation. For a medical emergency, call 911.
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