Medicare doesn't cover membership fees for concierge care.
You pay 100% of the membership fee for concierge care.
Concierge care is when:
- A doctor or group of doctors charges you a membership fee.
- They charge this fee before they’ll see you or accept you into their practice.
- Concierge care may also be called concierge medicine, retainer‐based medicine, boutique medicine, platinum practice, or direct care.
When you pay this fee, you may get some services or amenities that Medicare doesn’t cover.
Doctors who provide concierge care must still follow all Medicare rules:
- Doctors who accept "Advance Beneficiary Notice of Noncoverage” (ABN) listing the services and reasons why Medicare may not pay. can’t charge you extra for Medicare-covered services. This means the membership fee can’t include additional charges for items or services that Medicare usually covers unless Medicare won’t pay for the item or service. In this situation, your doctor must give you a written notice called an
- Doctors who don’t accept assignment can charge you more than the for Medicare-covered services, but there’s a 15% limit called the " ."
- All Medicare doctors (regardless of whether or not they accept assignment) can charge you for items and services that Medicare doesn’t cover.