Anyone here have a personal (concierge) Dr?  I was recently informed that my primary is switching his practice to this.  Just read the contract and it's $2100. annually.  Uh, I cannot afford this on top of the outrageous deductibles I have.  I absolutely am pissed that my health care decisions are now being based on COST!!  Insurance companies and Doctors not making $$ can try to kill me, but I won't go quietly, and I refuse to go broke. I'd rather use my money for travel, and I have a wedding to help pay for next year.

So, I realize most of you are way younger than me.  I was just curious if any of you pay for this?

I just reached out to a Penn primary doc to see about switching.

I did find a little work around with high deductible bills.  When I get a large bill, I send what I can for a few months until the charge disappears from the statement. I then wait until I receive a settlement offer from a collecting company.  It's usually around a 40% discount, so a $3500 deductible is now reduced by $1,400. or there abouts.  It may take a few years, but this is when I pay it off with the 1 time payment offer. Suckers.

21 minutes ago, DiPros said:

Anyone here have a personal (concierge) Dr?  I was recently informed that my primary is switching his practice to this.  Just read the contract and it's $2100. annually.  Uh, I cannot afford this on top of the outrageous deductibles I have.  I absolutely am pissed that my health care decisions are now being based on COST!!  Insurance companies and Doctors not making $$ can try to kill me, but I won't go quietly, and I refuse to go broke. I'd rather use my money for travel, and I have a wedding to help pay for next year.

So, I realize most of you are way younger than me.  I was just curious if any of you pay for this?

I just reached out to a Penn primary doc to see about switching.

I did find a little work around with high deductible bills.  When I get a large bill, I send what I can for a few months until the charge disappears from the statement. I then wait until I receive a settlement offer from a collecting company.  It's usually around a 40% discount, so a $3500 deductible is now reduced by $1,400. or there abouts.  It may take a few years, but this is when I pay it off with the 1 time payment offer. Suckers.

Yes, I have a concierge doc. There are different levels -- the guy I use has a patient limit, is on call 24/7, comes to me if I'm sick or need tests/blood/etc. A lot of doctors now are doing a lower cost version (sounds like what your guys is doing) to try and get guaranteed income that isn't reliant on insurance companies who always push back. It's also a way for them to drop less profitable Medicaid patients. 

FWIW, I think getting my guy was the best healthcare move I've ever made. As an example, last year I randomly lost hearing in my left ear. If I were just a regular patient, it would have taken 2 months to get into an ENT and I would never have recovered. My guy got me in with the best guy at Cedars in 24 hours, and luckily they saved me hearing. But that's for the higher end, much higher cost. I'm guessing your doc's service will remain basically the same. 

11 minutes ago, vikas83 said:

Yes, I have a concierge doc. There are different levels -- the guy I use has a patient limit, is on call 24/7, comes to me if I'm sick or need tests/blood/etc. A lot of doctors now are doing a lower cost version (sounds like what your guys is doing) to try and get guaranteed income that isn't reliant on insurance companies who always push back. It's also a way for them to drop less profitable Medicaid patients. 

FWIW, I think getting my guy was the best healthcare move I've ever made. As an example, last year I randomly lost hearing in my left ear. If I were just a regular patient, it would have taken 2 months to get into an ENT and I would never have recovered. My guy got me in with the best guy at Cedars in 24 hours, and luckily they saved me hearing. But that's for the higher end, much higher cost. I'm guessing your doc's service will remain basically the same. 

Meniere's? They give you a shot of cortisone?

11 minutes ago, we_gotta_believe said:

Meniere's? They give you a shot of cortisone?

Sudden sensorineural hearing loss

They don't know what causes it -- it's generally an infection of some kind gets to the ear nerve. It was a couple months after I had COVID, so they think that may have been the cause. I had to take Prednisone and get shots of steroids directly into my ear drum (about as pleasant as it sounds). I also had to do hyperbaric treatments, which is basically going into a tank for 90 minutes that simulates going to like 60 feet below sea level. Took about 2 weeks to come back. 

1 minute ago, vikas83 said:

Sudden sensorineural hearing loss

They don't know what causes it -- it's generally an infection of some kind gets to the ear nerve. It was a couple months after I had COVID, so they think that may have been the cause. I had to take Prednisone and get shots of steroids directly into my ear drum (about as pleasant as it sounds). I also had to do hyperbaric treatments, which is basically going into a tank for 90 minutes that simulates going to like 60 feet below sea level. Took about 2 weeks to come back. 

That's crazy, good to hear you recovered. The owner of Lonestar restaurants got tinnitis from covid that never went away and he committed suicide because it was unbearable to live with. Three years in and we're still learning new things about the pathology of it. 

That's crazy just randomly losing your hearing.  Glad all is well.  Thanks for your input.

 

It reads to me like he is dropping patients that don't sign on by Dec. 15.  I imagine his patient load is less geriatric now and this is the right choice for him.  I really liked him too; I just cannot afford it although it would be nice to have a doc at my beck and call. I've really learned a lot with caring for parents and in laws, and then Mr. Di's and my own health issues, so here's hoping I find a good Doc in the Penn system and that I can remain my own advocate while navigating all these changes.

1 hour ago, vikas83 said:

My guy got me in with the best guy at Cedars in 24 hours, and luckily they saved me hearing. 

A shame they couldn't treat it before it turned you Irish, though. 

1 minute ago, Kz! said:

A shame they couldn't treat it before it turned you Irish, though. 

On the plus side, my tolerance for whiskey has improved greatly. 

2 hours ago, DiPros said:

I absolutely am pissed that my health care decisions are now being based on COST!! 

This is Merica!    Go broke paying for doctors, or ignore your health and spend your money elsewhere.  That's the way it's always been here! 

2 hours ago, DiPros said:

I did find a little work around with high deductible bills.  When I get a large bill, I send what I can for a few months until the charge disappears from the statement. I then wait until I receive a settlement offer from a collecting company.  It's usually around a 40% discount, so a $3500 deductible is now reduced by $1,400. or there abouts.  It may take a few years, but this is when I pay it off with the 1 time payment offer. Suckers.

This is why health costs are booming. Doctors have to charge more to make up for the losses when they sell off these bad debts... If a debt collector can make a profit from 60% of your medical bill, they are paying your doctor maybe 5% or 10% of the bill to buy the debt. Big business is always going to win. Patients will lose. 

I'm a little embarrassed to admit this, but this is the 1st I've heard of this trend.  One question Di, does the $2100 annual fee cover everything for your doctor?  No additional bills on top of it?  I realize you'll have to pay other doctors if they send you there, just wondering about your primary who you would be paying this fee to.

We lost when the passed the ACA bill. 

 

3 minutes ago, The_Omega said:

I'm a little embarrassed to admit this, but this is the 1st I've heard of this trend.  One question Di, does the $2100 annual fee cover everything for your doctor?  No additional bills on top of it?  I realize you'll have to pay other doctors if they send you there, just wondering about your primary who you would be paying this fee to.

The annual fee is administrated by Signature Health.  It includes an annual visit up to 1 hr. and having the ability to reach him 24/7-365 and getting same day or next day appts. As far as I can tell, that's what this fee pays for.

  

1 minute ago, DiPros said:

The annual fee is administrated by Signature Health.  It includes an annual visit up to 1 hr. and having the ability to reach him 24/7-365 and getting same day or next day appts. As far as I can tell, that's what this fee pays for.

  

Yeah, that sounds like a bad deal.  From what I've read about since you started this thread it sounds like it should cover all office visits and in-house tests (lab work would likely go through insurance still), which would make it a little more appealing.

18 minutes ago, The_Omega said:

I'm a little embarrassed to admit this, but this is the 1st I've heard of this trend.  One question Di, does the $2100 annual fee cover everything for your doctor?  No additional bills on top of it?  I realize you'll have to pay other doctors if they send you there, just wondering about your primary who you would be paying this fee to.

It's been popular for a while at the higher price point -- I've had my guy since 2018. The more traditional concierge service is basically 24/7, 365 access to on care medical. Beyond the ear thing I mentioned, even the mundane is covered -- if me or my wife are sick, the doctor is usually over to see us in a few hours max. I text him directly if I need anything. All his time is part of the annual fee (which is substantial), but any lab work or tests need to be paid for. 

The recent expansion more broadly with more affordable versions I think it less concierge and more just guaranteeing continuing access.  

7 minutes ago, vikas83 said:

 

The recent expansion more broadly with more affordable versions I think it less concierge and more just guaranteeing continuing access.  

Yeah, this is the more affordable version for us poorers 😄   If I was younger, I would consider this.  Heck, back in the late 80's and 90's I had the insurance company paying me for being healthy.   I miss those days.  It is all so different. 

 

Sounds like a way for primary doctors to cut out the middleman, the network providers. Instead of the dr being part of a network and getting appointments scheduled out at a constant 2-3 month backlog, they establish their own network of people who agree to the concierge fee.

Other than always being "on call” for their group, they probably have less checkup appointments and still make referrals for most cases that require more attention.

Does using a concierge primary doctor affect the in network/ out of network deductibles by your insurance provider?

Health Care costs are outrageous. Whenever I have deal with a lot of BS at work (which is often) I have stop and remind myself how good the benefits are. I have a heart condition, but don't pay extra for concierge service. I've had a few emergencies, and I have always been able to get a hold of my cardiologist or his partner for help when needed. Once was at like 4am. 

40 minutes ago, MidMoFo said:

Does using a concierge primary doctor affect the in network/ out of network deductibles by your insurance provider?

As I understand, the concierge fee is paid entirely out-of-pocket. It is not covered by insurance, so it would not count against the deductible. Everything else that would normally affect the deductible is the same. So if your doctor remains in-network, then the in-network rates apply, etc.

23 minutes ago, toolg said:

As I understand, the concierge fee is paid entirely out-of-pocket. It is not covered by insurance, so it would not count against the deductible. Everything else that would normally affect the deductible is the same. So if your doctor remains in-network, then the in-network rates apply, etc.

Correct. I pay my doc out of my pocket. Any medical visits with him are covered by the annual fee. If I need to see a specialist, get lab work, etc. that goes thru insurance. 

34 minutes ago, toolg said:

As I understand, the concierge fee is paid entirely out-of-pocket. It is not covered by insurance, so it would not count against the deductible. Everything else that would normally affect the deductible is the same. So if your doctor remains in-network, then the in-network rates apply, etc.

I get that and understand the patient benefit of agreeing to the concierge fee for direct access to the doctor and faster appointments, if you can afford it. I understand the benefit to the dr, they can be more selective with clientele and assuming they have less patients to tend but with the downside of being on call 24/7.

I don’t see the benefit to the healthcare network of having their doctors see less patients though and went straight to the assumption that this was a way for primary physicians to break away from a network and manage their own practice.

If people are going to advocate for lifestyle insurance as opposed to health insurance. You are going to pay for it.

5 hours ago, vikas83 said:

 I also had to do hyperbaric treatments

Do you ever lift weights at the end of your driveway?

7 hours ago, MidMoFo said:

I get that and understand the patient benefit of agreeing to the concierge fee for direct access to the doctor and faster appointments, if you can afford it. I understand the benefit to the dr, they can be more selective with clientele and assuming they have less patients to tend but with the downside of being on call 24/7.

I don’t see the benefit to the healthcare network of having their doctors see less patients though and went straight to the assumption that this was a way for primary physicians to break away from a network and manage their own practice.

Yes. This is a way for doctors to basically completely remove themselves from the insurance payor network. My doctor never deals with insurance companies for his income; his staff does deal with them for reimbursement of 3rd party expenses (labs, scans specialists, etc.), but that’s just for his patients’ convenience. 

19 hours ago, vikas83 said:

On the plus side, my tolerance for whiskey has improved greatly. 

Hey thats profiling…

16 hours ago, MidMoFo said:

I get that and understand the patient benefit of agreeing to the concierge fee for direct access to the doctor and faster appointments, if you can afford it. I understand the benefit to the dr, they can be more selective with clientele and assuming they have less patients to tend but with the downside of being on call 24/7.

I don’t see the benefit to the healthcare network of having their doctors see less patients though and went straight to the assumption that this was a way for primary physicians to break away from a network and manage their own practice.

Perhaps. Or maybe it can be a hybrid, providing in-network services with added concierge services for a fee on top. For the practice, the concierge fees are guaranteed income upfront with low overhead. Going through the third-payer route: they have to spend time coding and file paperwork, paid in pieces by collecting copays and deductibles and reimbursements...   

The current pay for service system, and the rates at which they are reimbursed by insurance, means doctors will squeeze in as many patients as they can see in a day.  More patients = more fees they can bill and collect. As a patient, this is why you will be sitting in an exam room for what seems like an eternity, doctor comes in a rush, and (depending on the exam) you get maybe 5 minutes with the doc before they rush out to see another patient. Some primary care doctors think this does not allow them time to conduct a proper exam, leading to more follow up visits and further problems. Because the concierge service allows doctors to see less patients, they can spend more time getting to know their patients, becoming more like a partner in their health. The concierge fee is already paid upfront, guaranteed, so they set the rate at which it frees them up to be an advocate for their patients.  As a patient, you decide if this is the level of service you expect from your doctor and if the concierge fees are worth it.