Does Insurance or Medicare Cover Concierge Medicine?
How concierge medicine works with insurance and Medicare: what the membership fee is, why it is not billed to insurance, and how you keep your own coverage for the rest of your care.
Published February 20, 2026 · 2 min read
The short answer
A concierge membership fee is generally not billed to insurance or Medicare, because it pays for access and time beyond a standard billable visit. At Seth Premier Medical the membership is a separate fee, paid out of pocket and not billed to insurance, and it does not replace your coverage: you keep your insurance and Medicare for labs, imaging, prescriptions, hospital care, and specialists.
The membership fee vs your insurance
The concierge membership is a separate fee for the relationship with your physician: 24/7 access, same or next-day visits, longer appointments, and care coordination. That fee is not billed to insurance, because it covers access and time rather than a billable procedure.
Your medical care still runs through your own insurance. You keep your plan for bloodwork, imaging, prescriptions, hospital care, and outside specialists, and we review how your specific plan works with the practice when you enroll. The membership sits alongside your coverage, it does not replace it.
Medicare and HSA or FSA funds
If you have Medicare, you keep it and use it for covered services; the membership is a separate fee for the non-covered access and amenities. Because the rules around concierge care and Medicare are specific, we walk you through exactly how it works for your situation.
Many members are able to use HSA or FSA funds toward the membership. Rules vary by plan, so confirm with your administrator, and we provide documentation to help.
