Yes, but not in the way people usually expect. The membership fee at a concierge practice is not a health insurance product and is not billed to your insurance company. It is a separate annual fee that covers access to the physician himself. Your existing health insurance, including Medicare, stays in place and continues to cover the same things it always has: hospitalizations, imaging, specialist visits, prescriptions, and lab work billed by outside facilities.
The confusion usually comes from the word membership sitting next to the word medicine. People assume one replaces the other. It does not. At Boca Raton Concierge Medicine, the annual fee pays for the primary care relationship itself: extended appointments, direct access to Dr. Stein, same-day availability, and the coordination work that happens between visits. Everything that gets billed through a claim, meaning nearly everything that happens outside the primary care relationship, still runs through your insurance exactly as it did before you joined.
For patients on Medicare specifically, this distinction matters even more. Medicare does not cover concierge membership fees, and no concierge practice can bill Medicare for the annual fee itself, regardless of how the practice is structured. What Medicare continues to cover, and how a given office visit gets billed, depends on the physician’s Medicare participation status: full participation, non-participation, or having opted out of Medicare altogether. That status changes the billing mechanics in ways worth understanding upfront. It is a fair and necessary question to ask directly before joining any concierge practice, including this one, since the answer affects what you can expect your insurance to handle once you are a member.
Private insurance works on the same underlying principle. If you carry a PPO, an HMO, or a high-deductible plan, that coverage does not change because you joined a concierge practice. Claims for covered services still go through your insurer the same way they always have. What changes is what happens before a claim ever gets filed: more time with the physician to figure out what actually needs to be tested or treated, faster access when something comes up, and a physician who has time to look closely at a specialist’s recommendation before it becomes your treatment plan.
This is also where people sometimes compare the wrong two numbers. They weigh the membership fee against their insurance premium, as though the two are competing for the same job. They are not. Insurance is built to absorb the cost of expensive, unpredictable events. It was never built to fund an unhurried, ongoing relationship with a physician who has time to know your case in depth. That gap is what the membership fee actually pays for, and it exists whether your insurance is excellent or thin.
A few costs sit outside both insurance and the standard membership fee, and it is worth naming that plainly rather than leaving it for later. Elective services outside core primary care, certain advanced diagnostics ordered beyond standard indications, and any care obtained from providers outside the practice are billed according to their own separate rules. A direct conversation with the practice before joining is the clearest way to understand what applies to your specific situation, since coverage details vary by plan and by patient.
One detail worth asking about specifically is whether a health savings account or flexible spending account can be applied toward any part of the membership fee. The IRS rules on this are narrow and depend on exactly how the underlying services are structured, so the answer is not the same at every concierge practice. It is a question your account administrator and the practice can both help answer, and for members who carry one of these accounts it can meaningfully change the out-of-pocket math.
Medicare publishes its own plain description of how concierge and retainer-based practices interact with the program, and it is worth reading directly rather than relying on secondhand summaries. The Medicare.gov page on concierge care coverage explains what the program does and does not pay for when a beneficiary joins a retainer-based practice.
The most reliable way to understand your specific situation is to ask directly before you join. A conversation with Dr. Stein will cover your current coverage, what stays the same, and what the membership fee adds. Reach the practice at (561) 483-5500 or through the contact page. Full membership details are on the membership page, and a breakdown of what the annual fee typically runs in this market is in our article on concierge medicine pricing in Boca Raton.