Tired Of Dealing With Insurance Hassles? Could Concierge Care Be Right For You?

If you find yourself wading through piles of insurance paperwork and bills every time you visit your doctor for an appointment, or if you've grown weary of long waits in crowded waiting rooms each time you need an updated prescription for a recurring medication, you may be wondering about your options. With the upheaval in the health insurance and healthcare industries over the last decade, many physicians have moved to a concierge care model: taking on only a select number of patients who pay an annual fee and cutting out the insurance companies entirely. Read on to learn more about some of the benefits and potential drawbacks of jettisoning your primary care physician (PCP) for a concierge care doctor so you'll be able to make the most informed decision possible.

What benefits do patients see from concierge care? 

Many patients under the care of a concierge doctor report that this arrangement has brought them back to the "good old days" of medicine, where patients don't feel rushed in the examination room or worry about undergoing unnecessary tests simply to justify the cost of a visit. 

Because concierge care doctors don't bill insurance (although patients are sometimes free to submit these claims to their insurance carrier on their own), they have more time to attend to patients' needs directly, and can often significantly reduce their office's administrative overhead costs in the process. 

In addition, concierge care doctors' ability to take on only as many patients as they can handle often means you'll be able to get in for an appointment quickly. The monthly or yearly fee you pay to your doctor's office should cover the cost of a physical exam and one or more "free" appointments over the course of the year. You'll also have a better handle on the costs you'll incur for each additional doctor visit and procedure; although you'll have to pay these costs out of pocket, there can be some comfort in the predictability of knowing what you'll be charged. 

Those who have chronic conditions that require regular monitoring or medication adjustment, like diabetes, lupus, or even HIV, can often benefit from a concierge care doctor; the ability to forge a relationship with a single doctor who is up-to-date on your medical history, prior bad reactions to a course of medication, or other factors can ensure your treatment path is designed with your best interests in mind.  

What are some of the potential drawbacks of pursuing concierge care instead of keeping your PCP?  

Concierge care isn't always the perfect choice for everyone, and it's important to have a handle on both the high and low points to ensure you've considered all the factors.

Concierge doctors set their own rates, and with inflation, these rates are unlikely to drop in the near future; if you're already teetering at the edge of affordability and don't anticipate any raises in your own future, you may find yourself priced out of concierge care after a few years, making it tougher to get back into your PCP's practice.

Those who are (fortunately) healthy enough to never see a doctor may also not gain as much benefit from the concierge care model than those who require regular treatment. While paying your annual concierge care fee can "hold your spot" in your physician's practice, failing to take advantage of the complimentary appointments can mean a lot of money spent without any care to show for it. You may want to instead reserve this option for the future, when you're both better able to afford and more in need of a physician who provides concierge care. 

For more information, contact a local family doctor.