Concierge Medicine vs Direct Primary Care: Understanding the Differences

Both models offer personalized, accessible healthcare, but they work differently. This guide helps you choose the right approach for your needs in Albuquerque, NM.

Physician talking with an older male patient across a desk in a medical office

Side-by-Side Comparison

Feature

Concierge Medicine

Direct Primary Care (DPC)

Monthly Cost

Typically $150 to $600+ per month

Often $75 to $150 per month

Insurance Required

Yes, typically

Patient Panel Size

Limited, often a few hundred patients

Limited, often several hundred patients

Same-Day Appointments

Usually available

Direct Doctor Access

Phone, text, email

Annual Retainer Fee

Often charged

Rarely charged

Services Included

Enhanced amenities, extended visits

Primary care visits and direct access; extras vary by practice

Insurance Billing

Yes, billed to insurance

No insurance billing

Best For

High-income patients with comprehensive insurance

Those seeking affordable, transparent care

Ranges above are typical national figures, not Body1MD prices. Body1MD's membership is $100/month under age 50 and $150/month at age 50 and up, month-to-month, with no annual contract and no annual concierge retainer.

Concierge Medicine: Premium Service with Insurance

Concierge medicine practices charge a monthly or annual retainer fee on top of traditional insurance billing. In exchange, patients receive enhanced services: longer appointment times, same-day or next-day availability, 24/7 access to their physician via phone or text, and a more personalized healthcare experience. The physician maintains a smaller patient panel, typically a few hundred patients compared to 2,000 or more in traditional practices, allowing for more attentive, unhurried care.

Concierge practices still bill insurance companies for covered services, so patients continue to use their existing health insurance for office visits, lab work, imaging, and specialist referrals. The retainer fee covers the enhanced accessibility and amenities. Think of it as a VIP membership that sits alongside your regular health plan.

This model appeals to high-income professionals, executives, and families who want premium access and convenience while maintaining comprehensive insurance coverage. Monthly fees typically range from $150 to $600 or more per person, depending on location and service level. Some practices also charge a separate annual fee.

Direct Primary Care: Transparent, Insurance-Free Care

Direct primary care (DPC) operates entirely outside the insurance system. Patients pay a flat monthly membership fee, often $75 to $150 per adult nationally, and in return receive primary care visits and direct access to their physician without insurance claims at the practice. There are no insurance copays or deductibles for the membership itself. Exactly what a membership includes varies by practice, so it is worth asking before you join.

Because DPC practices don't bill insurance, they eliminate the administrative overhead and restrictions that drive up costs and limit time with patients. This allows physicians to keep panel sizes deliberately small and spend far longer with each patient than the short visits common in traditional settings. Patients can usually call or text their doctor directly.

DPC is ideal for individuals and families seeking affordable, accessible primary care without navigating insurance red tape. Many DPC patients pair their membership with a high-deductible health plan or health-sharing ministry for catastrophic coverage. The DPC fee is not insurance and doesn't cover specialists, hospitalizations, or major procedures, but it handles routine primary care with transparency and simplicity.

Where Body1MD Fits

Body1MD is a direct primary care practice in Los Ranchos de Albuquerque led by Dr. Andrew Hemmen, a board-certified internal medicine physician. Membership is $100 per month under age 50 and $150 per month at age 50 and up, month-to-month, with no annual contract and no annual concierge retainer, and Body1MD does not bill insurance. Members get visits designed to last up to an hour, same- or next-day appointments in most cases, and direct phone and text access to Dr. Hemmen: concierge-level access through a straightforward monthly membership.

How to Decide Which Model is Right for You

Choose Concierge Medicine if you:

Have comprehensive employer-sponsored or private insurance you want to keep using
Value premium amenities and concierge-level service alongside insurance coverage
Can afford a concierge retainer (often $150 to $600 or more per month) in addition to your insurance premiums
Want enhanced services like executive physicals, wellness coaching, or travel medicine
Prefer the familiar structure of insurance billing with added accessibility

Choose Direct Primary Care if you:

Are self-employed, uninsured, or have a high-deductible health plan
Want simple, transparent pricing without copays, deductibles, or surprise bills
Prefer to avoid insurance altogether and pay directly for care
Value longer visits and direct doctor access at a predictable monthly cost
Want personalized, relationship-based care without the premium price tag

Frequently Asked Questions

Can I use insurance with direct primary care?

DPC practices do not bill insurance for their services. However, you can (and should) maintain a high-deductible health plan or catastrophic insurance to cover hospitalizations, surgeries, imaging, and specialists. Many DPC patients find this combination more affordable than traditional insurance with lower deductibles, since the DPC membership handles routine primary care outside the insurance system. Body1MD does not bill insurance, and many members keep a plan for hospital care, specialists and imaging.

Is concierge medicine covered by Medicare?

Concierge practices typically accept Medicare, but the monthly or annual retainer fee is not covered by Medicare and must be paid out-of-pocket. The practice will bill Medicare for covered services like office visits and procedures, just as a traditional practice would. Some concierge practices do not accept Medicare at all, so it's important to ask before joining.

What services are included in a DPC membership?

It varies by practice. Most DPC memberships include primary care visits, prompt appointments, direct access to your physician by phone or text, chronic disease management, and care coordination, while what else is bundled (labs, procedures, medications) differs widely from one practice to the next. Services not typically included: specialist visits, hospital care, advanced imaging (MRI, CT), and surgeries. At Body1MD, the membership covers primary care with Dr. Hemmen; optional wellness and performance services are separately contracted and priced, and the office can explain how outside labs, imaging and prescriptions are handled before you join.

Which model is more affordable for a household?

Direct primary care is typically the less expensive of the two, because DPC fees are usually lower and there is no large annual retainer. Some DPC practices that also see children offer family pricing. Body1MD is an adult internal medicine practice, so each adult member pays $100 per month under age 50 or $150 per month at 50 and up; two members under 50, for example, would pay $200 per month together. Concierge practices typically charge a retainer per person, which can add up quickly for a household, on top of existing insurance premiums.

Can I switch from concierge medicine to DPC (or vice versa)?

Yes. Most concierge and DPC practices operate on a month-to-month or annual membership basis, and you can change practices if your needs or financial situation changes. Review your membership agreement for any notice requirements or cancellation terms. Body1MD's membership is month-to-month, with no annual contract. Your medical records can be transferred to your new practice. Many patients find that trying one model helps them understand which approach aligns better with their healthcare priorities and budget.

Still Not Sure Which Model Fits Your Needs?

Let's discuss your healthcare goals, budget, and priorities. We'll help you understand which approach, concierge or direct primary care, aligns best with your situation in the Albuquerque area. Call (505) 645-5451.

Discuss Your Options