Concierge Medicine and Medicare: What You Need to Know
One of the most common questions we hear from people considering concierge medicine is:
“Can I join a concierge medical practice if I have Medicare?”
The answer is yes.
At Rivanna Concierge Physicians, Charlottesville’s concierge primary care practice, we welcome Medicare patients. We are credentialed with Medicare and the major health insurance plans in our area, and we bill insurance for covered medical care just as a traditional primary care practice does.
The annual concierge membership and your health insurance work together. Your insurance is used for covered medical care, while the membership provides the enhanced access, time, and personalized services that are central to our concierge model.
What Does the Concierge Membership Include?
Membership includes:
- Same- or next-day appointments when you are sick
- Longer, unhurried appointments
- Minimal waiting when you arrive
- After-hours availability for urgent medical concerns
- More personalized preventive and wellness planning
- Help coordinating care with specialists and other healthcare professionals
- An annual full-body DEXA scan for body composition assessment
- A functional movement assessment conducted by our partner physical therapist
The membership fee is not billed to Medicare or your health insurance.
How Does Medicare Work With Concierge Medicine?
When you receive medical care that is covered by Medicare, we bill Medicare for that care.
For example, if you come in to evaluate a new medical problem, manage a chronic condition, or receive another Medicare-covered service, we submit the appropriate claim to Medicare. Medicare then processes the claim according to your coverage.
The same principle applies to patients with commercial insurance. We bill the patient’s insurance for covered medical services. Covered office visits, labs, and imaging are billed to your insurance, just as they would be at a traditional practice.
Joining a concierge practice does not mean giving up your health insurance or paying out of pocket for all of your medical care.
What If I Have Medicare Advantage?
Medicare Advantage plans are administered by private insurance companies and have their own networks and coverage requirements.
We currently participate with select Medicare Advantage plans from Anthem, Humana, and UnitedHealthcare. If your plan is from another company, or you’re not sure whether your specific plan is included, contact our office and we will confirm how your coverage works at Rivanna Concierge Physicians.
Patients with Original Medicare can use their Medicare coverage for covered medical services provided by our physicians.
Why Choose Concierge Medicine If You Already Have Medicare?
Medicare provides important health insurance coverage, but it does not necessarily provide the level of access, time, and physician relationship that many people want from their primary care doctor.
This matters more as healthcare gets more complex with age. Managing multiple medications, specialists, preventive screenings, new symptoms, and chronic conditions can require more time and coordination than a traditional primary care model allows.
At Rivanna Concierge Physicians, we deliberately maintain a smaller patient panel so that we can spend more time with each patient. We believe excellent primary care goes beyond the problem of the day. It means knowing our patients well, listening carefully, thinking proactively, focusing on preventive care, and having the time to coordinate care when needed.
The Bottom Line
You do not have to choose between Medicare and concierge medicine.
At Rivanna Concierge Physicians, you keep your Medicare or other health insurance and use it for covered medical care. Your concierge membership gives you the additional access, time, and personalized attention that define our practice.
If you are considering concierge medicine and have Medicare, Medicare Advantage, or another form of health insurance, we are happy to answer your questions and explain how the model works for you.
Learn more about membership at Rivanna Concierge Physicians.
