I think the pertinent question is: how often do you go to the doctor? I've gone to urgent care twice, and the cost was covered by my insurance.

This situation can get really tricky and I would encourage you to talk to an insurance broker to ensure you have the coverage you need. Typically, you will want a PPO plan that has in-network providers in both the states where you reside.

Between you, do your routine doctor's visits cost the two of you $1000 a month?

Will you be able to save more than $6000 a year on your insurance for the two of you?

This is essentially higher access to your physician, in addition to requiring regular insurance, although perhaps lower cost insurance.

However with lower cost insurance you generally have a higher deductible, so you will still end up paying out of pocket unless you need something expensive.

My former primary transitioned to being a concierge doctor and I bounced.

I have never quite figured out who was supposed to benefit from concierge care beyond someone who needed many routine visits throughout the year, and I am a healthcare provider.

Although not exactly the same, providers in my profession opt out of participating with insurance plans and moving to accepting insurance in order to work less and make the same amount of money. Of course this only works in practices with more affluent patient pools.

My DH and I snow birded between CA and PA for 6 years before moving permanently. 6 months at a time in each. I had insurance through ACA in PA for that entire time, my DH for 4 of the 6 years. No additional insurance. I made all my appointments for when I was in PA. Never had to visit urgent care in CA. My DH did visit urgent care a few times in CA, it was covered through our insurance. I think our insurance would've covered any emergency care.

Actually there were a number of patients in the practice I worked in who maintained all of their healthcare here and coordinated appointments in Pennsylvania during trips back from Florida. The majority of them did not have a primary physician or dentist in Florida because essentially none of them left for six months and never came back north once during the period. Actually a number of them still flew back for haircuts and Botox and the rest, and just planned it in with other things.

We have had the same PCP for around 20 years. About 10 years ago he and his partner went to MDViP and we went that way. It is not insurance. The costs have gone up but are still worth it to us for the benefits of time spent with our doctor, the yearly comprehensive physicals, and other benefits (including almost no timemspent waiting in his waiting room.

we have great insurance, even with Medicare, because i have a Blue Cross retiree supplement and we also have Tricare thanks to DH’s military service. I don’t know if you are aware burt most concierge medical services include access to other MDs and specialists in their network anywhere in the country. So would assume you can use another doctor in CT, which I think I would prefer over an urgent care clinic. Unless of course you need an after-hours or weekend visit. I would check into it at any rate and see if there is a doc in the same network in CT that will be willing to see you for the months you are there, as needed.

We have a PCP in two states. So far we’ve been doing the annual wellness visit in MN and the establish care visits with a PCP in SC. We’re on the 4th attempt to find an acceptable PCP. So we’ve had appts with both each year since we’ve been in SC. Quality of healthcare in MN is far superior to SC but I eventually hope to find acceptable providers for all our needs in SC. For now all of our specialists are in MN because we can just plan ahead and schedule during the four months we're there. As difficult as it's been to find an acceptable PCP in SC, I refuse to pay for a concierge physician at this time. Our needs would have to become much more complex for me to consider it. In my opinion the biggest beneficiary of concierge medicine are the doctors. They have a more manageable schedule and can spend the time necessary to know their patients well and provide the highest quality patient care. And that's good for the patient too if you have medical needs that would benefit from the higher level of attention.

You can buy insurance that covers you primarily in your state of residence but also when traveling.

For now at least, we rarely see our Dr.s or use urgent care, so it would make no sense,. And our PCP (in Boston) is amazingly responsive via text. I feel very lucky.

I can certainly see it for anyone with a serious medical condition, or again, where resources in a certain market are scarce or unresponsive. We are seen the same day for sick visits. Wellness visits can take many months, but they offer you cancellations if you opt in for that and that works really well. I never wait at all; you text to confirm the day of, text when you arrive, etc, and they whisk you in. Best managed practice I've ever dealt with. They also bring you bottled water, which was new for me.

Wow, I have never had a dr who texted me.

I was surprised yesterday at the MOHS office, they had a basket of snacks in the waiting room.

Many healthcare providers would not text or email because it violates standard HIPAA procedures unless it's fully encrypted. I have a doctor who communicated with me via email before the hospital implemented Epic with the MyChart function but that was also pre-HIPAA. I've had good luck with MyChart or other patient portals with nearly every healthcare provider I've seen. Just one didn't respond and I'd already decided to fire him after my one and only visit.

Communications with the Dr. are text messages via Mychart.

The system that reminds me of an appointment, then prompts me to confirm the morning of, and prompts me to notify when I have arrived, then prompts automated check in, is text. I'm guessing this system is part of the reason why there is virtually no waiting time.

When the nurse takes your vitals, they offer you bottled water.

Oh - I thought you meant text messages that go directly from one phone to another. I think Epic's MyChart feature is one of the best things that's ever happened for patients. Some physicians gripe about using it but I think most who couldn't get on board have now retired.

Yes, I also like being able to refer to visit notes.

My pcp is concierge. I pay $2300 a year. I often question the value since I dont go to the pcp very often. Im more likely to go to a specialist for various things.

However when I hear the complaint of people who have very long waits for appointments, or have to get through a firewall to reach their doctor, I decide to pay the cost of convenience,

My doc is part of MDVIP and I get messages and notes through the AthenaPatient portal.

I also have Medicare and AARP supplemental insurance. I think I am paying too much for someone who is generally healthy but I like the feeling of being covered no matter the situation.

when I hear the complaint of people who have very long waits for appointments, or have to get through a firewall to reach their doctor,

I agree; I am just saying there is no reason to assume that will be the case.

That is pretty reasonable for concierge. Ours is now charging $8K/year for new patients. Ours loses money with my DH and makes money off of me, so probably comes out even for the year!

Being able to get an appointment quickly can be a big positive. Quick population growth in FL the last 5 years has meant that many doctors are booked several months out.

I have never had primary care in two states - one PCP and keep all scheduled care there. Looking back, I may have an unplanned illness or injury need every two or three years. If my PCP or DH's went to a concierge service, I would definitely consider it because we would would want to follow our doctors, but I don't know that I would seek out concierge level care as long as I'm happy with my PCP.

For your situation, do you require routine visits that would need to be in FL or will the ones you want to keep in CT cover all of that? Are you sure your insurance in CT would not cover you for urgent care, illness or injury in FL? Three plans seems like too much to me. Where it sounds like it would work is if you are in FL full time or get primary care there and it could supplement basic medicare or a catastrophic policy and concierge would be primary care. I don't think $6,000 yr in case you have an illness or injury that requires an office visit but not hospital care.

It's all based on location and individual needs, and also a bit of luck. I'm in Chicagoland, and run on routine maintenance at this point. My GPs have used MyChart for about a decade, so I'm able to get prompt responses the few times a year I log in. I hear the MyChart app is great, but I haven't used it.

One family member lives in a semi-rural location, and at one point considered a concierge service because of a diagnosis for which she assumed her treatment options were limited. But, fortunately, she found a wonderful specialist about an hour away. They text one another directly, but it's a pretty unique situation.

My BIL in another state recently had questionable bloodwork results and localized pain. He tried to book an appt with a hematologist, but the earliest availability was 2 months out. He ended up going to the ER, and after a weeklong hospital stay and several tests, has been diagnosed with a rare blood cancer.

Ded, $2300/yr seems reasonable, actually, for peace of mind. I write that after paying my annual homeowners' insurance premium, knowing I probably won't need it this year... but who knows? It's there if I do.

Mtn, I hope you're not drinking that bottled water. ;-)

LOL, of course not, @Feathers11!!

He tried to book an appt with a hematologist, but the earliest availability was 2 months out.

I think that is very common with specialists, but IME it ends up being much quicker because of cancellations and or one's PCP placing a call to the specialist. Thank goodness he persisted.

Yes, and that's where the bit of luck comes in. I've shared my sister's cancer experience here and there on this board (she's the one I reference above who texts directly with her doctor). She has a very aggressive type of cancer with grim outcomes, statistically, and it was diagnosed as stage 4b. When her initial lab work came back from her gyn, he referred her to a surgical oncologist, who met with my sister the next day during the dr's lunch hour. In the meantime, I was ready to fly down to NM, where she lives, and drag her back to Chicago for treatment. I made a lot of assumptions about her treatment options there, which have since been proven wrong.

My sister has had a recurrence, and her dr consulted with a panel of experts at MD Anderson, the top rated cancer center in the country, and has her on a targeted therapy that seems to be working. I talked with my sister yesterday and asked her how she was feeling. She said she was a bit tired because she just finished playing 5 rounds of pickleball! She's a rock star, and she's done everything right, so I give her a lot of credit. But finding her doctor was pure luck.

Mtn, oh okay, I have MyChart too. Like 3katz, I was thinking you were getting regular texts.

I have been satisfied with my medical care except for the wait to see a specialist or annual physical.

I get text alerts on my phone and then go to the app on my phone.

You need to understand your insurance plan to know what is needed.

I don't know of any plans that don't have an out of network option for when you are traveling.

Your primary doctors may allow for telehealth visits when you are traveling.

Some insurance companies have nationwide networks that you can access.

Some people change their insurance plan when they switch states. (If you move from one state to another you qualify for a special enrollment period.)

You probably don't need two different PCPs. Make your annual appointments when your in CT. If you happen to get sick while in FL go to the closest urgent care or ER.

No personal experience but close friends of ours have this service. They live in the Palm Springs area. They are 66 and 68 years old, have Medicare with a Supplement, no network requirements. They are very happy with the concierge doctor. They can get right in for primary care, which is almost impossible in their area. As with other concierge doctors they limit the number of patients in their practice. The physicians also seem to have a direct line to the specialists in the area. That said, the last couple of years our friends have been diagnosed with issues that required expedited treatment so it is likely they would have been fast tracked anyway. Another plus was the concierge doctor stayed in communication with the specialist and took much more interest in their care than most of our doctors would have the time to do.

I see a doctor who recently transitioned to this concierge model. She's sort of an integrative medicine provider who I started seeing for thyroid issues. But she's been incredibly helpful at diagnosing and treating some other issues (digestive issues including giardia, h. pylori, and gluten intolerance). Typically I do about one annual visit with her and blood draws. In the past I would pay per visit out of pocket (refused to take insurance) and would have insurance pay for the lab work on blood. Honestly, I am very annoyed by this model. She's essentially getting much more money out of me for no additional service. But I haven't found another doctor who has been able and willing to treat my thyroid issues in a way that works for me, so I put up with it. If I was starting over and just looking for more of a general care provider, I would never go with this concierge route.

Once I was established with my primary, there has never been an issue with getting into see them in a timely manner for routine things. Same with specialists. I have waited a few months to see certain specialists (and have gotten to see others rather quickly) but once I am in their system, having interaction with the within a relatively short period of time has not been an issue for me (?)

Also, if the first primary I had here, or the current one I have here were to switch to concierge, I would consider it if it were not too costly. The one I left when he went that route was not worth the extra fee.

I have had my cardiologist’s cellphone number for three years and have only texted him twice. He responded immediately. DH has his oncologust’s mobile number; idk how often they correspond. Before electronic medical records DH gave his cell phone to all his patients so they could call or text if they really needed to talk to him. Interestingly, they never abused it. He was unusual though in that he also made the occasional house call to a post op patient who could not make it to the office for a follow up visit or if the weather was so bad he didnt want them to get out in it.

Okay, please don't take offense , but my concern about the concierge model is that it is yet another example of the more well-to-do having a huge advantage over those who cannot afford their prices. I might be less bothered if we had universal health care, so even the poor could receive good healthcare. The others could still pay extra for concierge service if they wish, but at least everyone is covered and that is a big deal.

So, that is why I would not go to a concierge practice. Just me and of course, only an opinion that most do not share which is fine. Life wold be so dull if we all thought alike about everything. :-) As an aside, we have never had a problem getting in to see our doctor who is terrific with communication. One thing I miss from childhood, though, are house calls when someone is sick.

I hear you, Cyn.

As a retired RN I agree wholeheartedly @cyn427 (z. 7, N. VA). 🙏c

We will see more and more concierge practices, limited to those who can afford concierge service. We are seeing more and more private practices purchased by both insurance companies and equity firms, who are looking at medical care as a means to profit their stockholders. Low cost, minimal care = greatest profits.

in 1980 76% of physicians were practice owners with the majority of the rest employed by a hospital.

Today 77% of physicians are employed by hospitals, health systems, or other corporate entities

The rich will have quality health care while the rest of us will get profit based healthcare.

I don’t think there are that many in my area. i actually don’t know anyone that uses one. Not that I know what dr everyone uses, but that us one of the most frequent questions on my communith FB group; what physician to use and I have never heard a concierge mentioned there. I do remember someone I worked with joined one and that was the first i heard of it. I don’t think it’s for us. We gi to a group with my husband seeing one dr and i see a different one. There is a PA in the group and several NP i addition and if your dr is not available for quick access, one of those are. Thankfully we are not often at the dr other than yearly physicals. I did have a stopped up ear last year and my dr was able to get me in with a specialist quickly. 😊

Universal health care is never truly universal or equal either. Those who can afford a better plan or have better work coverage, will get that knee replacement next month when the rest of the masses have to wait 18 months to get one. The doctor is going to perform the surgeries that provide them with income first.

We need insurance industry reform and not really health care reform. That middleman is really the problem.

The doctor is going to perform the surgeries that provide them with income first.

How very cynical; I’m sorry if the physicians you know deal with patients that way.

Florida resident here of almost 13 years in a popular snowbird area. PCP appointments are very difficult to obtain even when ill due to large numbers of snowbirds in season. I have found many middle age and older PCP move to Florida to escape the weather and take on a PCP position and the realize the concierge position is a better option for their lifestyle. I have had many of my PCPs do this necessitating a new doctor for me. Pay attention to how old this PCP is as I have said a fair number of the concierge docs are on the older side and may be close to retirement. My DH and I have discussed this option but am staying with a regular PCP for now. I think it is a good choice however even for a part timer. I would not feel guilty about taking care of my health no matter which option you chose.

How very cynical; I’m sorry if the physicians you know deal with patients that way.

Read the whole paragraph. This isn't physicians I know, but the systems we have in place. I have family in the UK and unless you have private insurance or willing to pay out of pocket, you are going to be waiting years for procedures that aren't deemed "critical", but could really improve your quality of life, like the knee replacement I mentioned. Doctors practicing today did not choose these systems, they just work as best they can with them and some choose to provide private/paid services.

@chispa - do docs in the UK choose first to perform surgeries that pay them more? I was under the impression the NHS paid providers a salary, not incentive based comp but I could certainly be wrong. I do know people in the UK who have private insurance because they want more flexibility in where they go and don't want to get on a waiting list. I always assumed the docs covered by private insurance were not the same ones working for the NHS.

I do think people who wish for universal coverage/medicare for all do not have a complete understanding of how this works in other countries.

I mentioned to someone recently, who favored medicare for all, that I thought our entire health care system would collapse if all reimbursement came from medicare. Facilities and providers would go broke at that level of payment. Not to mention medicare itself is going broke with the number of people covered now and some providers just won't accept medicare. And some just bail out and go concierge so they don't have to deal with the challenges of third party reimbursement.

Chispa, the connotation of your comments is that in the queue of patients, those who can pay go to the front of the line— which seems to be what 3katz is asking. In fact there are two different systems in countries with socialized medicine, one that covers everyone and a parallel, private pay system that operates i dependently of the NHS. People receiving care under universal coverage wait longer; that’s a known fact that is not in dispute.

There is room for improvement in every health care delivery system, but you cannot ignore that the US spends more than twice per capita on healthcare than our peer countries and has the worst outcomes and is one of the most inequitable systems.

(https://www.commonwealthfund.org/publications/fund-reports/2024/sep/mirror-mirror-2024)

Having a short wait time for a knee replacement doesn't matter if you are living pay check to pay check and have to save $6k to pay your deductible. I know a guy who was told he should have a knee replacement over 10 years ago and just got it this year because he finally became eligible for Medicare and I helped him find a plan (Plan N) that wouldn't require a $6k outlay of cash in order to get the surgery. Germany manages to have both low out of pocket costs and low wait times for knee replacement surgeries.

Well really we have kind of a trilevel system where people at the very bottom of income pyramid, have a bit more access to some care, either Medicaid or other types of things that exist, that aren't accessible to poor people who make "too much". The teaching program I work in provides free care, but the patient has to be able to spend long appointment hours, multiple visits. (In this program we have had patient have to drop out when they get a new job, not because they can afford care, but they can no longer meet the appointment times.) In the program I see patients in, they are covered under federal and state grants, and much of the federal has been cut or the income guidelines have been raised. The patients who have been bumped out because of income are still low income. But they make "too much" to have access to care, not that they can afford it anywhere else.

The other thing that happens is that even with an insurance plan that is employer provided, what usually happens is that the working class employees have the cheapest plan with the highest deductible which they never hit. So they are paying for insurance that they don't really get to take advantage of with routine care because they have a $5000 deductible. But at the upper end of the spectrum, the top tier employees may have fully paid 0 deductible insurance as part of their package and have no out of pocket for routine care and no premium to pay.

I had one of the wealthier patients in the office say "If health insurance made sense, I would have a $50,000 deductible because that's how much I would feel comfortable having to pay out of pocket if necessary, before it really had much effect on me, and the person who cleans this office would have the low deductible insurance because they need it. Because it's likely that I would use a few thousand of that a year, just like the people at the bottom do, who never hit their deductible. The difference is, it wouldn't wipe me out to have to pay for something expensive, if I had to, on occasion.

I belong to a concierge practice but only because the doctor who correctly diagnosed my neuropathy as a side effect of B12 deficiency, joined one, He’s the only doctor who encourages my B12 treatment plan and doesn’t act as though I’m asking for a controlled substance when I need a refill of B12. I don’t know what I’ll do when he retires. Otherwise, I’m happy with the group practice I belong to and will persue that avenue when we begin spending half the year in Florida next winter.

One thing I will say is that the life expectancy in the US is lower than that in Canada and EU. countries. That could be due to better preventive care services in those countries. I am not a patient at a concierge practice and honestly, I would not want to be.