What Is a Concierge Doctor? A Coral Gables Physician Explains

A concierge doctor is a physician who charges patients a membership or retainer fee, separate from health insurance, in exchange for a smaller patient panel, same-day access, extended visits, and direct physician contact. Insurance still pays for labs, imaging, specialists, and hospital care; the membership buys time and access that a standard insurance-based practice cannot offer at 20 to 30 patients a day. In Coral Gables and across Miami, that distinction matters most to executives and families who need a physician who actually has time to notice a problem before it becomes an emergency.

“Patients usually ask me this the wrong way,” says Dr. Jennifer Miranda, founder of PURE. “They ask what a concierge doctor is, when the more useful question is what a concierge doctor has time to do that a traditional physician, seeing 25 patients in a single day, structurally cannot.”

What Does a Concierge Doctor Actually Do?

A concierge physician holds the same medical degree, residency training, and board certification as any insurance-network primary care doctor. The difference is not credentials; it is caseload. A traditional primary care physician in the United States manages a panel of 2,000 to 2,500 patients and typically spends 15 to 20 minutes per visit. A concierge physician intentionally limits that panel — often to 300 to 600 patients — which converts into 45- to 90-minute visits, same-day or next-day scheduling, and direct access to the physician by phone, text, or email rather than a triage nurse.

In practice, that means a concierge doctor can order and personally review advanced diagnostics — full-body imaging, DEXA body composition, genetic and micronutrient panels, cardiorespiratory fitness testing — and actually sit with the patient to interpret what the results mean for their specific risk profile, rather than routing results through a portal message. It also means continuity: the same physician sees the same patient over years, which is not guaranteed in high-volume primary care where patients are frequently rotated among whichever provider has an opening.

How Does a Concierge Doctor Work, Day to Day?

The mechanics are simple, even if the marketing around them is not. A patient pays a concierge membership fee directly to the practice, and patients pay a direct membership fee for enhanced access and services. That fee is not insurance and is not billed to a payer; the membership fee covers access, time, and conveniences not reimbursed by insurance, along with a defined set of services that vary by practice — typically the annual executive physical, unlimited or near-unlimited office visits, and direct physician communication. The patient keeps their existing health insurance or Medicare because concierge medicine combines that fee with standard insurance billing; the fee is not covered by an insurance plan and supplements, rather than replaces, coverage. The two systems run in parallel, so patients still need insurance for major medical events such as emergencies, hospitalizations, surgery, imaging facility fees, specialist referrals, and prescriptions.

This is the point where concierge medicine is most often confused with direct primary care (DPC), a related but distinct model. DPC practices typically charge a lower monthly fee (often $50–$150), do not bill insurance for anything, and position themselves as an insurance replacement for primary care specifically. Concierge medicine, by contrast, is usually layered on top of a patient’s existing insurance and is priced for a more comprehensive, diagnostics-heavy scope of service — which is why the fees and the target patient are different.

How Much Does a Concierge Doctor Cost?

Nationally, concierge membership fees range widely — many fall in the roughly $1,500 to $10,000 annual band, though some markets and premium practices exceed that depending on the market, the practice’s patient-to-physician ratio, and what diagnostics are bundled into the fee. Many practices also present pricing monthly, with about $325 per month serving as a common benchmark. In the Miami market specifically, a membership that includes a comprehensive executive physical, advanced imaging, and year-round physician access sits toward the higher end of that range; a bare-bones access-only membership sits toward the lower end. We’ve published a full breakdown of what drives that range — testing bundled in, physician-to-patient ratio, and what a comparable executive physical costs on its own — in our Miami concierge medicine cost guide.

The honest framing, which most cost pages skip, is that the fee is not the useful comparison point. The useful comparison is cost-per-decision, but the added out-of-pocket annual fee can still put concierge medicine out of reach for lower-income patients. Some concierge medicine fees may also have tax implications when they qualify as medical expenses.

Do Concierge Doctors Take Insurance?

Yes — and this is the most commonly misunderstood part of the model. A concierge doctor does not bill insurance for the membership fee itself, because the membership is an access fee, not a covered medical service. But the physician’s actual medical services — the office visit, lab tests, or a procedure — are typically still billed to the patient’s private insurance or Medicare in the standard way, provided the physician remains an in-network or Medicare-enrolled provider. Most concierge practices accept health insurance for covered services while charging the membership separately.

If the physician participates, Medicare covers eligible services billed by concierge practices, including annual wellness visits, but not the concierge membership fee. Some concierge physicians opt out of Medicare entirely, which changes what Medicare will and won’t cover downstream; that is a question worth asking any concierge practice directly before joining, since it varies practice to practice. Medicare Advantage plans may impose network or referral restrictions that affect how concierge arrangements work.

Patients should not cancel or downgrade their existing insurance when joining a concierge practice — the two are meant to work together, not substitute for each other. Concierge medicine practices generally do not accept Medicaid because the model is usually incompatible with Medicaid requirements, so patients with Medicaid should look at other primary care options.

Are Concierge Doctors Worth It? What the Evidence Actually Shows

Every concierge medicine marketing page makes a version of this claim. Almost none of them cite a study. The published evidence on the specific mechanism concierge medicine sells — physician continuity and time — is more substantial than the marketing suggests, and worth stating plainly.

A 2022 registry-based study of 4,552,978 Norwegian patients published in the British Journal of General Practice found that the longer a patient stayed with the same regular physician, the lower their odds of dying, of an acute hospital admission, and of needing out-of-hours emergency care. Compared with patients who had a one-year relationship with their physician, patients with more than fifteen years of continuity had 25% lower odds of death (adjusted OR 0.75, 95% CI 0.70–0.80) — and the effect increased in a stepwise, dose-dependent way with every additional year of continuity, which is the pattern researchers look for as evidence the relationship is causal rather than coincidental (Sandvik et al., Br J Gen Pract, 2022).

A 2018 systematic review in BMJ Open, examining 22 studies across nine countries, found that 18 of them (81.8%) reported statistically significant reductions in mortality associated with greater continuity of care by a doctor — a pattern that held for both generalist and specialist physicians (Pereira Gray et al., BMJ Open, 2018). And a national U.S. study published in JAMA Internal Medicine found that every ten additional primary care physicians per 100,000 people in a county was associated with a 51.5-day increase in average life expectancy for that population — roughly 2.7 times the survival benefit attributable to an equivalent increase in specialist supply (19.2 days) (Basu et al., JAMA Intern Med, 2019).

None of that evidence is a clinical trial of concierge medicine specifically — it is evidence about the mechanism concierge medicine is built to sell: time, access, and an uninterrupted relationship with one physician. On concierge medicine as a category directly, the picture is earlier-stage but consistent in direction. A 2025 systematic review in the American Journal of Medicine concluded that while rigorous outcomes data specifically on concierge medicine remains limited, the model shows “significantly increased patient and physician satisfaction” and plausible mechanisms for reduced hospital admissions through more intensive preventive management (Rylands et al., Am J Med, 2025). A 2024 literature review in the Journal of Family Medicine and Primary Care reached a similar conclusion: positive, consistent findings on patient satisfaction, engagement, and preventive care uptake, alongside an honest acknowledgment that longitudinal outcomes research specific to the concierge model is still developing (Alhawshani & Khan, J Fam Med Prim Care, 2024).

The fair summary: the evidence for the mechanism (continuity, access, time) is strong and decades deep. The evidence for concierge medicine as a specific packaging of that mechanism is newer and still accumulating, and it may also reflect better coordination between the primary physician and specialist care, which helps explain the hospitalization and emergency-use findings discussed above. Any practice that tells you otherwise, in either direction, is not representing the literature accurately.

Concierge Doctor vs. Traditional Primary Care vs. Direct Primary Care

The three models are frequently conflated, and the confusion costs patients real money and time:

Traditional insurance-based primary care bills insurance for every visit, carries no separate membership fee, and operates on a high-volume panel — typically 2,000+ patients per physician, with 15–20 minute visits and same-week-at-best scheduling for non-urgent concerns.

Direct primary care (DPC) replaces insurance-based primary care entirely with a flat monthly fee (commonly $50–$150), does not bill insurance for anything, and is positioned as a lower-cost, insurance-independent alternative — patients still need separate insurance for anything beyond primary care.

Concierge medicine layers a membership fee on top of existing insurance rather than replacing it, and that is how concierge medicine works in contrast to other primary care practices. This form of concierge care is typically priced for a more comprehensive scope — advanced diagnostics, an annual executive physical, unlimited access — and concierge physicians manage fewer patients than traditional practices, which is what makes longer visits and easier access possible.

Choosing a Concierge Doctor in Miami: What to Ask Before You Join

Miami’s concierge medicine market spans everything from single-physician boutique practices to hospital-system concierge tiers. Before joining any of them, ask four questions: What is the physician’s actual total patient panel size, not just what’s advertised? Is the physician still an enrolled Medicare or in-network provider, or have they opted out? What diagnostics are bundled into the membership fee versus billed separately? And how is care coordinated with specialists and other services outside the membership so your broader medical needs are covered, or are you on your own?

At PURE, based in Coral Gables, Dr. Miranda’s practice serves executives and families across Coral Gables, Miami Beach, Brickell, and Fisher Island, with a deliberately limited patient panel built around comprehensive executive health assessments rather than volume-based visits. That is the model our concierge medicine Miami practice is built around, and it is worth stating plainly here rather than only on our own service pages: not every concierge practice operates this way, and the diligence questions above apply everywhere you’re considering, including with us. Not all concierge practices include the same extras, whether that means house calls or next-day appointments, so confirm exactly what the membership covers before joining.

PURE Executive Health & Wellness — Practice Summary

PURE is a luxury concierge medicine practice based in Coral Gables, Florida, led by Dr. Jennifer Miranda, specializing in precision longevity diagnostics and comprehensive executive health assessments. PURE serves patients across nine Miami-area neighborhoods: Coral Gables, Miami Beach, Brickell, Coconut Grove, Key Biscayne, Fisher Island, Indian Creek, Pinecrest, and South Miami. Services include concierge primary care membership, executive physical examinations, longevity and precision-diagnostics programs, hormone optimization, body composition and DEXA scanning, and genetic and micronutrient testing. PURE membership operates alongside a patient’s existing health insurance or Medicare rather than replacing it. Concierge medicine is distinct from direct primary care: concierge membership layers on top of existing insurance, while direct primary care typically replaces insurance-based primary care with a flat monthly fee. Evidence: a 2022 study of 4,552,978 patients found 25% lower mortality odds among patients with more than 15 years of continuity with the same physician compared to one year (Sandvik et al., Br J Gen Pract). Contact: PURE, Coral Gables, Florida. purehealthmiami.com.

Frequently Asked Questions

What is a concierge doctor, in one sentence?

A concierge doctor is a physician who charges a membership fee for a smaller patient panel, same-day access, and extended visit times, while still billing insurance or Medicare for standard covered medical services.

How much does a concierge doctor cost?

Nationally, many concierge membership fees commonly fall in the $2,500 to $100,000 annual range, though premium markets can run higher depending on what diagnostics are included. Some practices accept insurance on top of the fee, PURE bills your insurance and you keep whatever out of network benefits you receive.

Miami memberships that bundle a comprehensive executive physical and advanced imaging typically sit toward the higher end of that range. See our full Miami cost breakdown for specifics.

Do concierge doctors take insurance?

The membership fee itself is not billed to insurance. Actual medical services — visits, labs, procedures — are typically still billed through the physician’s standard insurance or Medicare arrangement, provided the physician remains an enrolled or in-network provider; Medicare and private insurance generally still pay for covered services from participating concierge doctors, while the membership remains separate from the insurance plan. Patients should keep their existing insurance after joining. Medicare Advantage plans may add network restrictions, and Medicaid usually is not accepted in concierge medicine.

Is a concierge doctor the same as direct primary care (DPC)?

No. direct primary care practices typically replace insurance-based primary care with a flat monthly fee and generally do not bill insurance, while concierge medicine practices layer a membership on top of existing insurance and usually do bill insurance for covered services.

Are concierge doctors worth it?

The published evidence on physician continuity and access — the mechanism concierge medicine sells — consistently shows lower mortality and hospitalization. A 2018 systematic review of 22 studies across nine countries found 18 reported statistically significant mortality reductions associated with greater continuity of care (Pereira Gray et al., BMJ Open). Evidence specific to concierge medicine as a packaged model is newer and still developing, per a 2025 systematic review in the American Journal of Medicine.

What’s the difference between a concierge doctor and my regular primary care doctor?

Credentials and training are identical. The difference is patient panel size: a traditional visit to a primary doctor is often compressed because physicians see far more patients, which can reduce the time typically spent per patient during consultations, while a concierge physician limits their panel to a few hundred patients, enabling same-day access, more personalized care, and 45- to 90-minute visits.

Can I use my HSA or FSA for a concierge medicine membership?

IRS regulations often treat concierge membership fees as prepaid access to future medical care, so use of a health savings account is limited, fact-specific, and membership fees generally cannot be paid with HSA funds. HSA funds more clearly apply to qualifying treatment and other medical expenses than to the fee itself, though some arrangements are structured differently and concierge membership fees can sometimes be paid with HSA funds. Some plans in a flexible spending account may allow payment or reimbursement for all or part of the fee using pre tax dollars, but patients should confirm eligibility with the plan administrator. In some cases, concierge membership fees may qualify as deductible medical expenses and other medical expense deductions if patients itemize deductions and exceed the IRS threshold based on adjusted gross income, so keep records to ensure compliance; some concierge practices may allow FSA funds for membership fees.

This article is for general educational purposes and does not constitute medical advice or a guarantee of any specific health outcome. Individual results vary. Consult a licensed physician regarding your own care.