Unable to find an internist who took Medicare: Concierge medicine

Harold and Margret Thomas, who are in their mid-70s and live in Cincinnati, spend the winter in Tucson. After many phone calls, the couple was unable to find an internist in Tucson who took new Medicare patients, so they signed with Dr. Steven Knope in 1996. Five years ago, when Margaret developed a blinding headache, her husband called the doctor at 8 pm one night, and he, suspecting an aneurysm, insisted they get to the Emergency Room immediately.

The doctor met them and ordered an MRI and CT scan. The test revealed an aneurysm, and Dr. Knope found a surgeon who quickly operated. Medicare paid for the emergency room, the surgery and the hospital stay.

"If there were a concierge practice in Cincinnati, I'd be part of it there, too," Harold said.

Concierge, or "boutique" care, comes in two forms. In the more popular form, doctors accept Medicare and other insurance, but charge patients an annual retainer of $1,600 to $1,800 to get in the door and received services not covered by Medicare, like annual physicals. Before signing up and paying the retainer, patients should get a written agreement spelling out which services the doctor will bill Medicare for and which the retainer covers.

The other form of concierge medicine is more expensive. Fees range as high as $15,000 yearly and cover office visits, access to the doctor when care is needed, referrals to specialist, and thorough annual physical exams.

Advice to wealthy seniors whose doctors don't accept Medicare: Consider a concierge practice.

Read a story about a medical home.

Thanks to Julie Connelly for the source article in the New York Times of April 2.