Understanding Your Coverage
Concierge medicine works alongside your health insurance, not instead of it. Here's how it all fits together.
Yes, you should keep your health insurance. Your AnswersMD membership covers your primary care relationship: the time, access, and attention of your personal physician. Health insurance covers everything else: hospitals, specialists, major procedures, and catastrophic care.
Think of it this way: your membership ensures exceptional day-to-day care and a doctor who truly knows you. Insurance protects you from major medical expenses.
Many people wonder why they should pay for a membership when they already have insurance. The reality is that insurance is designed for major medical expenses, not for building a relationship with your doctor.
Insurance-based primary care forces physicians to see 25-30 patients per day just to keep the lights on. That's why appointments are rushed, wait times are long, and getting through to your doctor feels impossible.
Your membership buys you something insurance can't: time, access, and a physician who actually knows you. When a health crisis hits, that relationship can be the difference between a good outcome and a missed diagnosis.
We've had members whose early-caught cancers, prevented heart attacks, and properly diagnosed conditions were only possible because their doctor had the time to truly listen and investigate, not rush to the next patient.
We recommend maintaining comprehensive health insurance coverage. Your membership handles exceptional primary care. Your insurance should handle everything else with the same level of quality.
PPO Plans: Our top recommendation. PPO plans offer the most flexibility, allowing you to see any specialist without referrals and access care anywhere. When we coordinate your care with specialists or hospitals, a PPO ensures you have options.
We're happy to discuss your specific situation and help you think through what makes sense for your family.
Unfortunately, we are unable to accept patients with HMO plans, Tricare Prime, or Medicaid. These insurance types require that labs, imaging, and specialist referrals go through specific networks and approval processes that we cannot accommodate as an out-of-network concierge practice.
We wish we could serve everyone, but these insurers' restrictions prevent us from providing the seamless care coordination that defines the AnswersMD experience. If you're considering transitioning to a PPO plan, we'd be happy to discuss timing and options.
Concierge membership fees are generally not covered by health insurance. However, they may be eligible for payment through your Health Savings Account (HSA) or Flexible Spending Account (FSA). Consult your plan administrator or tax advisor for specifics.
We do not bill insurance for primary care services; those are covered by your membership. However, when we order labs, imaging, or refer you to specialists, those providers will bill your insurance directly.
While we strongly recommend maintaining health insurance for major medical expenses, your membership still provides exceptional primary care. We can help you find cost-effective options for labs, imaging, and specialist care when needed.
Membership is billed annually at the start of your membership year. We accept all major credit cards and can provide documentation for HSA/FSA reimbursement if applicable.
Your membership covers all primary care services with no copays or per-visit fees. The only additional costs would be for services outside of primary care (labs beyond routine panels, imaging, specialist visits) which are billed through your insurance or paid directly to those providers.
We're happy to walk you through how membership works with your specific insurance situation.
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