I have been researching Concierge Doctors in my area and have found that most do not accept patients who are Medicare age which confuses me since their model requires patients to pay a fee instead of using insurance. Well, Medicare is just another form of insurance isn’t it? Why would they not simply accept me as a patient, but not accept my Medicare for payment?
In general, I like the Concierge concept and would like to move in that direction, but the confusing point about not accepting Medicare patients is a stumbling block. If you’re a Concierge patient what is your experience with that model whether of Medicare age or not?
Medicare has federal law behind it. Taking care of Medicare patients is a different ball game and is not at all the same as private insurance.
That being said, there should be options for you if you look around.
We are literally not allowed to charge patients of Medicare age whatever we want. It is quite comical with stories of rich older people travelling to see some world renowned specialist and the hotel room is more than the surgeons fee. Let alone the airfare or private jet flight.
If you don’t participate in Medicare, you get to charge a whooping 15% above Medicare rates. You can completely opt out but that is a 2 year commitment and has lots of repercussions.
I just looked it up and 1% of doctors opt out but… 40% of those are psychiatrists.
Thanks for the information. That 15% above Medicare rates for Concierge doctors who would accept me does sound ridiculous and needs to be corrected. I am perfectly able and willing to pay what a Concierge doctor charges!
I don’t think the information in this thread is strictly accurate. I have been going to a concierge doctor for five years and I am on traditional Medicare. The federal law only stipulates that all medical services such as office visits and blood tests must be billed to Medicare. By definition, a concierge doctor has way fewer patients to attend and thus you get faster appointments and a quicker response for script refills. Nothing in that is prevented by the Medicare rules, My MD gave me his cellphone number too.
What is accurate is that Medicare is not the same as private insurance. So it is an explanation for why some concierge docs don’t take Medicare patients. I thought the membership fee would be a violation but it is okay if you follow the rules.
Violating Blue Cross rules gets me in trouble with a contract. Violating Medicare rules can get me put in jail. The default answer is always jail time.
Many doctors are adequately afraid of Medicare and their rules. Yes, you can charge a membership fee and still bill Medicare. But you are potentially playing with something that some doctors aren’t comfortable with. I would only do it with a lawyer’s advice and I don’t like to get lawyer’s advice …
Medicare will also sometimes claw back payments while you are investigated - which can take forever. No one wants that. State regulations protect physician from egregious private insurance practices but can’t help with Medicare.
Good memory! I did consult with Dr Fraser for a few months, but my concierge doc is actually someone I’ve been seeing for over a decade.
Many of my friends see him, and they are almost all Medicare age (he doesn’t take new patients so he’d be of no help). In fact, most of the docs in my town are concierge, and my Medicare aged friends see them too. Until today, I never knew this was an issue.