Three products sold under one name
| Model | How you pay | What it usually buys | Insurance still needed? |
|---|---|---|---|
| Concierge retainer | Annual or monthly retainer to a physician practice, often on top of billing your insurer for visits | A small patient panel, longer visits, direct phone or text access, coordination of specialist referrals | Yes. The retainer pays for access, and services are often still billed to insurance |
| Direct primary care (DPC) | Flat periodic fee to the practice; most DPC practices don't bill insurance | Unlimited or generous primary care visits, messaging, and often wholesale-priced labs and generic drugs | Yes, for hospital, specialist, imaging and emergency care |
| Executive physical program | Annual package, often paid by an employer, at a hospital or clinic center | A one- or two-day comprehensive assessment: physician exam, labs, imaging and specialist reviews arranged around the patient | Yes. Follow-up treatment is billed normally |
The names overlap in marketing, so read the contract, not the brochure. The key question is whether the fee pays for access (time, availability, coordination) or for services (visits, tests, procedures), and which services are explicitly excluded.
What the fees look like: one dated benchmark
Independent, recent price data for membership medicine is thin. Practices set their own fees, and many don't publish them. The most useful peer-reviewed benchmark we could verify is a survey of direct primary care practices published in the Kansas Journal of Medicine (Rowe et al., 2017). Of the 38 practices that responded in 2015:
- 88% charged an annual individual adult rate between $500 and $1,499 (USD).
- By comparison, in the authors' 2005 survey data, 81% of practices charged more than $1,500 a year.
- Only 11% of the 2015 practices submitted bills to insurance, down from 75% in 2005.
Two cautions. The survey is small and the data are more than a decade old, so treat the dollar range as a historical reference point, not today's market price. It also covers DPC, not concierge retainers or hospital executive physicals, which may price very differently. Ask any practice for its current written fee schedule.
What a membership tends to include, and what it leaves out
The same survey reported which services the 2015 DPC practices offered:
- Same-day appointments: 92%
- Electronic medical records: 84%
- Email access to the physician: 82%
- 24-hour access: 76%
- Wholesale-priced labs: 74%
- Inpatient (hospital) care: 16%
- Obstetrics: 3%
That pattern is typical of membership medicine. Fast access and primary care are the core product. Hospital care, surgery and most specialist care sit outside it. A membership can lower what you spend on visits and small tests while doing little for your exposure to a large bill. If large bills are your worry, our guide to what insurance actually covers is the more relevant read.
The abroad alternative is a pattern, not a product
There's no direct overseas equivalent of a US concierge retainer for someone living in the US. What some patients do instead is unbundle the membership into the parts they value and buy some of them abroad, pay-per-visit:
- Keep ordinary primary care at home, through an insurance-based doctor or a DPC practice, for continuity and prescriptions.
- Buy the comprehensive assessment separately, either at home or as a scheduled checkup during a trip. Our guide to executive checkups and preventive screening abroad covers how those packages are built.
- Use self-pay specialist consultations when needed, rather than paying every year for priority access. See specialist consultation fees around the world.
This costs you something real: the continuous relationship with one physician who knows your history and answers the phone. If that relationship is the main thing you'd be paying for, no pay-per-visit pattern abroad replaces it.
Executive physicals: the employer-paid version
Hospital-based executive physical programs are often bought by employers for senior staff, not by individuals. The appeal is time efficiency: a day or two in which the exam, labs, imaging and specialist reviews are scheduled back to back, with the results pulled together into a single report. If you're paying personally, three questions matter more than the brochure:
- Which tests are standard, and which are add-ons? Packages often have tiers, and imaging is the usual dividing line.
- Is each test justified for you? More screening isn't automatically better. Incidental findings can lead to follow-up tests and anxiety without changing your health. Ask the program's physician why each test is included for someone of your age and history.
- What happens to abnormal results? Follow-up visits, extra imaging or procedures are usually billed normally, outside the package.
The same questions apply to comprehensive checkups sold abroad. A shorter list of tests that are clearly indicated, done well and properly followed up, is worth more than a long list nobody acts on.
Where a membership fee fits in a household budget
A membership fee is an extra fixed cost on top of your insurance premium. It pays off only if it replaces spending you'd have had anyway: copays, cash visits, urgent care trips, or the cost of time lost to slow access. A simple test is to list last year's primary care contacts, what you paid for each and how long you waited, then ask whether the membership would have changed those numbers. If you rarely use primary care and are mainly buying reassurance, be honest that the fee buys availability, which may be worth it to you, rather than savings.
How to run the comparison with your own numbers
The table below is a worksheet, not a price list. Fill it in with quotes you've collected.
| Line | Membership path | Unbundled path |
|---|---|---|
| Annual fee or retainer | Written fee | $0 |
| Primary care visits you expect | Included, or billed to insurance | Insurance or cash, per visit |
| Annual comprehensive assessment | Included or extra | Package price at home or abroad |
| Labs and imaging | Included, wholesale, or billed | Cash or insurance price |
| Specialist consultations | Usually billed separately | Self-pay fee per consult |
| Travel for any care abroad | $0 | Flights, lodging, days away |
| Insurance premium | Still needed | Still needed |
Two lines often decide it. First, how many primary care contacts you actually use: if you rarely see a doctor, a fixed fee buys mostly availability. Second, whether you'd be travelling anyway: a checkup timed with a trip you were already taking has little extra travel cost, while a dedicated trip has a lot.
Questions to ask before you sign
- Is the fee for access only, or does it include visits, labs and drugs? Ask for the written list of exclusions.
- Does the practice bill insurance as well as charging the fee? For which services?
- What happens to the fee if you cancel mid-year? Is it refundable or prorated?
- Does the practice admit or follow patients in hospital, or hand off to other doctors?
- For tax-advantaged accounts, how does your plan administrator or tax adviser treat the fee? Don't assume.
- For any care abroad, how will results and records reach your home doctor?
The Takeaway
Price the parts, not the label. Membership medicine mainly sells access and primary care. If you value the continuous relationship, pay for it at home. If you mainly want a periodic comprehensive assessment and occasional specialist input, an unbundled, pay-per-visit pattern, sometimes partly abroad, may cost less. But insurance for large bills is still needed either way.
Frequently asked questions
What is the difference between concierge medicine and direct primary care?
A concierge practice usually charges a retainer for access and often still bills your insurer for visits. A direct primary care practice charges a flat periodic fee and usually doesn't bill insurance; in the 2017 Kansas Journal of Medicine survey, only 11% of DPC practices did.
How much do direct primary care memberships cost?
In a 2015 survey published in 2017, 88% of responding DPC practices charged individual adults between $500 and $1,499 a year. The data are old and the sample was small, so ask practices for their current written fees.
Does a health membership replace insurance?
No. Memberships focus on primary care and access. In the same survey, only 16% of DPC practices offered inpatient care, so hospital, surgical, specialist and emergency costs still need insurance or cash.
Is there an abroad version of an executive health membership?
Not usually as a single product for US residents. Some patients unbundle it instead: primary care at home, plus a comprehensive checkup and occasional self-pay specialist consults, sometimes during a trip abroad.
What should I check in a membership contract?
Check what the fee includes and excludes, whether the practice also bills insurance, the cancellation and refund terms, and who looks after you if you're admitted to hospital.