One of the most commonly asked questions in concierge medicine is about health insurance. Do you accept insurance? How does insurance work with concierge medicine? Does insurance cover the membership fee? Keep reading for answers to all your questions.
Membership at PartnerMD is an entirely separate fee from medical services, insurance, and associated billing. Membership fees are not covered by health insurance.
If you have an HSA or FSA plan through your employer, you may be able to offset a portion of the fee. We always recommend checking with your plan administrator to confirm.
Your membership fee includes benefits, such as:
Your membership can be paid annually, quarterly or monthly, with no change in fee based on payment schedule.
Contact the membership billing team at billing@partnermd.com or call 844.618.5055.
Your membership fee does not replace your health insurance. In general, your health insurance works the same at PartnerMD as it does with a traditional primary care practice.
We work with and bill your health insurance company for medical care, including office or telehealth visits, lab work, and tests.
You are responsible for co-pays or deductibles, but your health insurance will cover the costs of approved services and procedures, just as it would if you were seeing a traditional PCP.
Contact the Medical Billing team at medicalbilling@partnermd.com or call 844.618.5050.
When you get a bill from PartnerMD for medical services, there are a few categories that payment might fall under. Here are the key terms that you should know. Be sure to check with your insurance carrier to get details about your individual plan.
Reimbursement rates for medical services are part of the contract between PartnerMD and the insurance carrier. Balance billing refers to the difference between what PartnerMD charges and what the insurance carrier has agreed to pay. In the event that the insurance carrier pays less than the cost of the service, the patient is responsible for paying the difference.
As part of your insurance plan, you may be required to pay a portion of the cost for medical services. This is referred to as a co-payment. The co-payment fee structure should be available to you from the carrier with rates typically in place for office visits, specialist visits, emergency care, and more. Be sure to review the details of your plan to find your co-payment amounts.
Some insurance plans, and often Medicare plans, include a deductible. A deductible is a set amount that needs to be paid by you, the patient, before your insurance kicks in and starts picking up the tab. If you are new to Medicare, this may be a new experience for you. Review the documentation from your insurance carrier to find the details about your deductible.
Insurance plans vary based on your insurance carrier, your plan, and your individual selections.
The best way to ensure that PartnerMD participates with your insurance is to check on your insurance carrier's website.
To do this, visit the website of your insurance carrier. Look for the “provider lookup” tool. Enter the exact product name for your insurance and the practice and/or doctor name to confirm in-network status.
Send us a copy of your insurance card, and we can confirm.
If you recently changed jobs or your employer changed your health care plan, it's a great time to confirm that PartnerMD participates with your new plan. We recommend checking before you switch, if possible, just to avoid any confusion.
As you acclimate to a new way of experiencing healthcare, you may have more questions. We are here to help. The practice manager at your local office is available and happy to provide assistance. Give us a call during business hours.
You can also check the comprehensive FAQ page for members to find information about office visits, billing and insurance, and more.