What a private doctor to the wealthy really sells, what the research says it does for you, and the budget version you can now pay from an HSA.
This in-depth guide covers everything you need to know about concierge medicine cost: what the rich pay in 2026. Based on verified income data and real-world case studies from our database of 138 side hustle tactics.
Concierge medicine costs anywhere from about $2,000 a year to $40,000 or more per person as of 2026. The national network MDVIP averages about $2,500 a year per member, according to its CEO, while the top tier, firms like Private Medical, reportedly charges $40,000 per adult. Direct primary care is the budget version, with the American Academy of Family Physicians putting typical fees at $50 to $100 a month, and from 2026 you can pay it from a health savings account if the fee stays at or under $150 a month.
What you are paying for when you pay a doctor directly
Picture two waiting rooms. In the first, you call on a Monday, get a slot three weeks out, and spend twelve minutes with a doctor who is already running late. In the second, you text your doctor on a Sunday night, get a reply, and see them the next morning for as long as you need.
That gap is the whole product. Concierge medicine is a membership fee you pay a primary care doctor so they can carry far fewer patients and give each one more time. Some practices still bill your insurance for visits on top of the fee. Others take cash only.
How long did you wait the last time you booked a new-patient appointment? A 2022 Merritt Hawkins survey reported by Medical Economics found an average wait of 20.6 days for family medicine and 26 days across five specialties, based on calls to 1,034 offices in 15 large US cities.
The reason is arithmetic. KFF Health News describes primary care doctors who each care for "thousands of patients" in appointments of "15 minutes or less." A concierge doctor cuts that list down and charges the remaining patients to make up the lost income.
The three tiers, priced as of 2026
There is no single price for concierge medicine. The market splits into roughly three bands, and the top tier's reported fee is about sixteen times MDVIP's average. KFF Health News put the very low end at $199 a year for Amazon's One Medical in 2024, a membership that sits at the edge of the category.
| Tier | Example | Reported fee | What the fee covers | Insurance still billed? |
|---|
| National network | MDVIP | About $2,500 a year average (June 2026) | Smaller practice, yearly wellness program, next-day access | Yes |
| Hospital-branded | Massachusetts General Hospital's practice | "$10,000 or more" (KFF, July 2024) | Varies by practice | Varies |
| Family office for health | Private Medical | $40,000 per adult, $25,000 per child (client reports to CNBC, 2024) | Office visits, tests and in-office procedures; hospital care excluded | Hospital care is separate |
| Direct primary care | Independent local practices | $50 to $100 a month for adults (AAFP) | All or most primary care | No |
The middle: MDVIP and the national networks
MDVIP is the name most people meet first, often because their own doctor sends a letter announcing a switch. In a June 2026 interview with Managed Healthcare Executive, CEO Larry Kutscher said the average annual fee for individuals is approximately $2,500, and that MDVIP has 450,000 members and 1,400 participating physicians in 46 states. The same article says members can get office visits "within 24 hours of having a problem."
That works out to about $208 a month. Fees vary by doctor and city. KFF Health News described MDVIP and SignatureMD as charging fees in the "low four figures" and quoted one patient who pays $1,900 a year.
What does the fee buy? MDVIP practices have long been built around small panels. A 2012 PBS NewsHour report said the company limits practices "to no more than 600 people, but take insurance," and described one doctor who cut a practice of 3,000 patients "to just 400." The fee pays for that time plus a yearly wellness program, which a 2018 MDVIP press release described as "a comprehensive yearly health assessment that includes advanced diagnostic tests and screenings," with doctors "reachable 24/7 by phone."
The fine print matters here. Your insurance still gets billed for sick visits, specialists, labs and hospital stays, so you keep paying premiums, copays and deductibles on top of the membership.
The top: Private Medical and the "family office for your health"
This is where the very rich sit. In an April 2024 report by CNBC's Robert Frank, republished by NBC Connecticut, founder Dr. Jordan Shlain declined to give prices. Clients told CNBC the practice charges "$40,000 a year for each adult patient and $25,000 per patient under the age of 18." The fees cover "the cost of visits, tests and procedures in the office, but not hospitalization."
Run the numbers for a family of two adults and two children at those reported rates and you get $130,000 a year, before a single hospital bill.
Shlain's own framing is telling. "It's a family office for your health," he told CNBC, and "I will know everything about you to help you make the best decisions in your life." The report says the firm serves more than 1,000 wealthy families with a team of 135 and offers "24/7 on-call service, including home and office visits when needed," plus relationships with more than 4,000 specialists.
The Private Medical website lists offices in New York, Greenwich, Miami, Los Angeles, San Francisco and Silicon Valley, and promises "a data-driven yearly plan and comprehensive annual report," contact with your doctor "via email, text or phone, 24/7," and "Personalized, TSA-approved travel kits and worldwide medical evacuation jet services for crises." It publishes no prices.
If the phrase "family office" is new to you, the sibling post on what a family office is explains the money version that this model borrows its name from.
What the rich actually get for the money
Strip away the marble lobbies and the top tier sells four things.
- Time. Long visits and a doctor who already knows your history.
- Reach. Text or call at any hour, and someone who answers.
- Coordination. A doctor who books the specialist, chases the results and reads the report so you never have to.
- Travel cover. Kits, overseas contacts and evacuation plans for people who spend half the year abroad.
Notice what is missing from that list: a new drug, a hidden test, a better surgeon. The specialists and hospitals are the same ones you can reach with insurance. What the money buys is speed and a person who manages the system on your behalf.
Some longevity doctors take this further. CBS News reported in October 2025 that Peter Attia put the yearly cost of his program nearer $100,000 than $500,000, and the Peter Attia protocol post covers what that includes. Clinics that sell executive physicals and whole-body testing as a one-off package are covered in the longevity clinic and executive physical post.
Which of those four would actually change your health this year? For most people it is the first one, time with a doctor who knows them, and that is also the cheapest one to buy.
Direct primary care: the budget version
Direct primary care, or DPC, is the closest thing to concierge medicine at a normal price. You pay a flat monthly fee straight to a primary care practice. The practice does not bill your insurance at all.
The American Academy of Family Physicians says monthly membership fees "generally range from $50 to $100," that the fee "covers all or most primary care services," and that services "often include extended office visits, clinical and laboratory services, consultative services, care coordination and comprehensive care management." A separate October 2025 AAFP FAQ adds $20 to $49 for children and $100 or more for families.
Citing its 2024 direct primary care data brief, the AAFP puts the average DPC panel at about 413 patients, close to the MDVIP model, and reports that 99% of DPC practices offer same-day appointments. In its own words, compared with concierge care, "DPC usually involves lower monthly fees, does not bill insurance and covers a broader range of services."
How many are there? The DPC Frontier mapper currently lists 3,224 direct primary care practices across all 50 states and Washington, DC.
So for $600 to $1,200 a year you can get something that looks a lot like what MDVIP members get for about $2,500, and a small slice of what Private Medical clients get for $40,000.
What would you do with a doctor you could text? Most people answer: ask the small questions they never book an appointment for. That is where the value shows up.
The part DPC does not cover
DPC is primary care only. A broken leg, a cancer diagnosis or a night in hospital falls outside the membership. The AAFP says DPC practices "often suggest that patients get a high-deductible, wrap-around policy to cover emergencies," and that "some services may require additional insurance coverage."
Treat DPC as a front door. You still need insurance behind it.
The HSA rules for direct primary care in 2026
Here is the change that matters most in 2026. Until this year, joining a DPC practice usually cost you the right to put money in a health savings account. The One, Big, Beautiful Bill Act, signed July 4, 2025, changed that, and the IRS explained the details in Notice 2026-5.
What the notice says, in plain words:
- You can now have both. From months beginning after December 31, 2025, a qualifying DPC arrangement no longer counts as a disqualifying "health plan," so being a member does not stop you contributing to your HSA.
- The fee cap is $150 a month. The arrangement qualifies only if your total DPC fees do not exceed $150 a month, or $300 for an arrangement covering more than one person. The cap rises with inflation for taxable years after 2026.
- Annual billing works. The IRS gives the example that for 2026, a single person's fee "could be $1,800 for a year; $900 for six months; or $450 for three months."
- HSA money can pay the fee. The law lets HSA funds pay DPC fees, which normally fall under the rule against using an HSA for insurance.
- It has to be pure primary care. Care must come from family, internal, geriatric or pediatric physicians, nurse practitioners, clinical nurse specialists or physician assistants. It excludes procedures that need general anesthesia, prescription drugs other than vaccines, and lab work "not typically administered in an ambulatory primary care setting."
- The fixed fee must be the only payment. An arrangement that charges a membership fee "but bills separately for those items and services (through insurance or otherwise)" does not qualify.
Two details trip people up. First, an over-cap fee can still be paid from your HSA, but under the notice it "will disqualify the covered individual from eligibility for making HSA contributions while the individual is enrolled." Second, DPC fees do not count toward your high-deductible plan's deductible or out-of-pocket maximum.
That fixed-fee rule keeps concierge memberships that also bill insurance outside the new HSA treatment. An MDVIP-style practice bills your insurance for visits on top of the membership, which is exactly the setup the IRS excludes. KFF Health News noted in 2024 that concierge fees are generally not payable from an HSA or FSA, and the 2026 rule leaves that picture largely in place for practices that also bill insurance.
The same law also widened who can have an HSA in the first place, and the notice explains how. From 2026, bronze and catastrophic plans sold on an ACA exchange are treated as high-deductible plans for HSA purposes, even if they fail the usual deductible tests. For 2026, the IRS contribution limits are $4,400 for self-only coverage and $8,750 for family coverage.
Put that together and a self-employed person can now pair an exchange bronze plan with a $90-a-month DPC membership, pay the $1,080 yearly fee from pre-tax HSA money, and still put the rest of the $4,400 limit to work. If you file a Schedule C, the side hustle tax guide covers how the rest of your health and business deductions fit together. Check your own plan details with your HSA administrator before you enroll, because the IRS asked for public comments on parts of the notice and edge cases remain.
What the research shows
For all the talk of better care, the outcome data on concierge medicine is thin. Here is what exists.
Concierge medicine and mortality. The strongest independent study is a 2023 paper in the Journal of Health Economics by Adam Leive, Guy David and Molly Candon. A Penn LDI summary reports that for patients who enrolled in concierge practices, "Spending increased to 50% higher than before enrollment," with "no change in the patients' mortality rates." Patients' health status did not predict who joined; "neighborhood income level had a stronger influence on the decision to join."
The company's own numbers. A 2012 study in the American Journal of Managed Care reported that by 2010, hospital discharges for MDVIP's Medicare members "were 79% lower than the nonmember Medicare population." Several authors reported employment with MDVIP, and people who choose to pay a yearly fee for prevention are likely a different group from those who skip it. Read it as an association, with a conflict of interest attached.
The overall picture. A 2024 literature review in the Journal of Family Medicine and Primary Care concluded "there is a need of research data to show the association of concierge medicine and health related outcomes."
Direct primary care. The best-known analysis is a 2020 Society of Actuaries report by Milliman on one employer's health plan. After adjusting for age, gender and health status, the DPC option was linked to a 12.64% lower overall demand for care and 40.51% less emergency department use. The lower hospital admission rate did not reach statistical significance. The actuaries also estimated that adding the DPC option raised the employer's total nonadministrative plan costs by 1.3% once membership fees and other plan design changes were counted. One employer, two years, some real benefits, and no proof of lower spending overall.
So what does a fair reading look like? Faster access and more time almost certainly make the experience better and may catch some problems earlier. Whether they make you live longer has not been shown.
Concierge sales claims to question
A few claims you will hear in sales calls and marketing copy deserve a hard look.
- "Concierge patients live longer." The independent 2023 study that tested mortality found no change after patients enrolled.
- "Our members go to hospital 79% less." That figure comes from a study written partly by company employees, comparing people who chose to join with people who did not.
- "The fee replaces insurance." For MDVIP-style practices, your insurance still pays for most care. Even Private Medical's reported fee excludes hospitalization, and DPC practices tell you to keep wrap-around coverage.
- "The annual physical needs to be a premium package." As KFF Health News notes, the Affordable Care Act requires insurers to cover many preventive services without out-of-pocket cost. The same article quoted a patient advocate asking why anyone would pay $2,000 for an annual physical.
- "More tests is better care." Extra testing brings its own costs and risks, including false alarms. The sibling post on full-body MRI goes through that trade-off in detail.
A plain note on safety: this is general information. Before you change doctors, drop a plan, or start or stop any treatment, talk it through with a clinician who knows your history. If you have a chronic condition, ask any new practice exactly how they handle specialists, prescriptions and hospital admissions before you sign.
Is concierge medicine worth it? A way to decide
Ask yourself four questions, in this order.
1. Do you have a doctor you can reach? If you already see a primary care doctor within a week and they answer portal messages, the marginal gain from a fee is small. If you have no doctor, or wait a month, the gain is large.
2. How much care do you use? A healthy 32-year-old who sees a doctor once a year is buying insurance against hassle. A 58-year-old with high blood pressure, a parent to look after and three specialists is buying a coordinator, which is worth much more.
3. Which tier solves your problem? Most people who want access and time get it from DPC at $50 to $100 a month. MDVIP-style care makes sense if you want your existing doctor and your insurance to keep working together. The $40,000 tier mostly buys coordination and travel cover for people whose time is worth more than the fee.
4. What happens if your doctor converts? This is a common way people meet concierge medicine. KFF Health News tells of a patient whose doctor started charging a fee in 2019: "You had to pay the fee, or the doctor wasn't going to see you anymore." She moved to a practice with no fee. If you get that letter, you have three choices: pay, find a DPC practice, or ask your insurer for an in-network doctor taking new patients.
A rough rule: if the fee is under 2% of your household income and you have a real access problem, it is a reasonable buy. If it would mean skipping retirement or emergency savings, a DPC membership or a better in-network doctor gets you most of the benefit.
Would you pay $2,500 a year to skip a three-week wait? Would you pay it if the money came out of your emergency fund? The second answer is usually the honest one.
The HSA as your health reserve
The rich tend to buy time with their doctor the way they buy time elsewhere, by paying someone so they never wait in a queue. The habit worth copying is the decision behind it: they price their own time and spend on what saves it.
For most readers the better move is the HSA. The IRS notice describes HSAs as accounts that "can receive tax-favored contributions" and pay medical expenses "on a tax-free basis." If your HSA provider offers investment options, a family that funds it every year and invests it in a low-cost fund can build a health reserve big enough to make the question of any fee a lot easier. The index investing guide covers the basics of that kind of portfolio.
If your budget is the real constraint, the guide to escaping the paycheck-to-paycheck cycle is the first step before any health membership. And if you happen to be a physician reading this from the other side of the desk, the doctor side income guide looks at ways to earn outside a crowded clinic schedule.
Your doctor-access plan this week
You can copy most of what the $40,000 tier sells for little or nothing.
- Check your access (free, 10 minutes). Call your current doctor's office and ask how soon you could get a sick visit and whether they answer messages. That tells you whether you have a problem to solve.
- Look up DPC near you (free). Search the DPC Frontier mapper for your zip code and note two or three practices and their monthly fees.
- Ask the HSA questions ($0). If you have or could get an HSA-eligible plan, ask a DPC practice whether its fee is fixed, under $150 a month, and free of any insurance billing. Those three answers decide whether the fee is HSA-friendly in 2026.
- Build your own health file (free). Collect your last labs, medication list, vaccine dates and family history in one document. This is the core of what a top-tier doctor builds for you.
- Use your free preventive care ($0 with most plans). Book the annual visit and screenings your plan already covers before you pay anyone extra.
- Price the gap ($50 to $100 a month). If you still want more time and access, a DPC membership is the cheapest real version of what the very rich pay for.
Which one will you do before Friday?