Membership medicine is an emerging model in medicine where the practice and the patient have a direct financial relationship. That means we work for you, not the health insurance company. Patients pay a membership fee to join the practice and use insurance for needs outside of primary care (for example, specialist visits, imaging, or hospitalization.) Once a member, patients pay no visit fee at all for primary care visits with the practice.
We offer an adult plan, a young adult plan, and a home care plan. These are outlined in more detail HERE.
Yes. For women who wish to continue their relationship with their current primary care provider but want to see me for menopause/perimenopause, sexual health, breast health, annual gynecologic exams, or other specific women’s health/gynecologic concerns, consults are offered. Patients do not need to become a member of the practice to schedule a consultation. Like the concierge practice, we will not bill insurance but will instead work directly with you for payment. Learn more about women’s health consultations HERE.
Yes. If you and your spouse (or domestic partner) wish to both join my concierge medicine practice, I discount the second membership to $3,000 annually ($6,250 annually for both). The young adult children (aged 16-25) of members are welcomed into the practice for just $1,250.
By starting my own membership-based practice, I can have a greater impact on my patients’ lives than I could have in a traditional primary care practice. By using the membership model, I can opt out of traditional health insurance. Rather than carrying a panel of 2,500 patients, I welcome just 350 into my practice. This allows us to spend more time together to focus on prevention, overall wellness, and the issues that matter most to you – not just treatment when you are sick. That is the way I think medicine should be.
Health insurance is important, and I absolutely recommend that patients have health insurance to help cover medical expenses, especially for specialty care and hospitalization. But the truth is, the out-of-pocket costs for patients are increasing year over year. Many patients (especially those with high deductible plans) never reach their deductible each year and pay completely out-of-pocket for their care. However, these patients are still being cared for in an outdated and under-equipped model of traditional primary care.
Today’s traditional, insurance-based, medical model works against patients. Doctors are expected to see 23-28 patients in a day, resulting in minimal time with each patient. The visit with your doctor lasts an average of 8-10 minutes. That is barely enough time to address immediate health needs, let alone focus on prevention and overall wellness. In fact, clinics are financially penalized when doctors do spend time providing preventive health care, because more time spent with individual patients means seeing fewer patients per day, which means less revenue.
Concierge medicine is an alternative payment model to insurance, so our office does not file insurance claims for you. You may be able to submit claims to your insurance directly for some services if your insurance plan offers out-of-network benefits. If you have a Health Savings Account (HSA), you may be able to submit invoices for HSA reimbursement. Dr. West is considered out-of-network for all insurances.
No. Annual membership fees are not covered by insurance. I have opted out of traditional health insurance. However, insurance often covers other related care, such as lab costs and vaccines as well as other specialists’ visits, hospitalizations, diagnostic imaging, etc. Patients who have Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) can receive reimbursement for some costs. Check with your third-party administrator. Our office will be happy to provide you with a receipt for specific non-membership-fee-related expenses including vaccines or point-of-care labs for you to submit to your carrier.
Dr. West is considered a non-participating provider of Medicare. Medicare will not cover a concierge membership fee. But with the concierge membership, individual visits with her are not billed. She can refer patients to specialists, hospitals, and imaging facilities. If a patient has a Medicare managed care plan, specialty visits, hospital stays, and imaging are typically covered by your insurance (unless you have a Medicare Advantage HMO or Health Maintenance Organization, which requires use of all in-network providers including your primary care).
Adult and Home Care concierge medicine members may pay on an annual or semi-annual basis. Young Adult membership is payable annually. If you’re not satisfied with your membership, you may cancel any time after the first six months – simply notify us in writing with 30 days’ notice of your intent, and we will issue a prorated refund.
Patients can cancel their membership at any time after the first 6 months by providing the office with 30-days written notice of cancellation.
Yes. Our practice has a limited capacity for patients, but if there is availability, a patient may rejoin the practice.
I understand. While the annual fee is not inexpensive, I’d encourage you to consider the amount of money you will spend out-of-pocket in an average year for your healthcare needs. Also, consider whether you are getting the kind of access, timeliness, and care you want from your provider.
Do you have chronic illness, a family history of illness, or concerns about your health that you have not had time to discuss with your primary care provider? Do you feel like you are getting expert advice about preventative measures you should take to reduce your risk of illness? Does your doctor address issues such as sexual health, menopause, bone health, and cancer risk with you?
Sometimes, the money you spend to prevent illness results in money saved should you become sick down the road and require extensive or long-term treatment. In fact, academic studies have shown that patients who belonged to a membership medicine practice had fewer emergency department visits and fewer in-patient admissions than those who did not. Unfortunately, good insurance coverage does not always translate into excellent care.
We are different from many boutique practices in that neither the practice nor the patient are burdened by insurance limitations. Many boutique practices charge significantly higher fees, from $3,500 to over $10,000, yet still bill insurance for individual visits at the higher insurance-contracted rates. The patient is still subject to visit restrictions, insurance denials, high deductible charges, and more. In our model, the cost of the visit with me is included in the membership fee.
Yes, we will be able to access your medical records through an HIE (Healthcare Information Exchange) that is accessed through our online electronic medical records system.
We can coordinate your visit to a specialist in your insurance network, and they will bill your insurance.
We think of “virtual visits” as a supplement to good primary care — not a replacement for in-person care. The office can offer these visits in some circumstances and when appropriate. Patients who would like to request a visit should contact the office for prior approval. In cases where a physical exam is necessary, we reserve the right to recommend a traditional clinic visit.
I have always had a special interest in women’s health, which is why I decided to dedicate my career to advancing excellent primary health care for women. Ms. Medicine is the first national concierge primary care model designed to address the complex medical needs of women comprehensively. Like me, Ms. Medicine physicians have received additional specialty training in women’s health, and our practices provide an exceptional level of care that addresses areas such as menopause, bone health, breast cancer risk assessment, cancer survivorship, and sexual health. Ms. Medicine embodies my belief that knowledge is power, and that by educating women about their bodies and health, we empower them to live their best lives.
To learn more about my practice and how to become a member, simply schedule a complimentary Meet & Greet with me. You may also reach out to our office at 571-999-9378, reach out through the “Let’s Connect” section toward the bottom of this web page, or email info@eileenwestmd.com.
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Also, you can learn more about Ms. Medicine at its website and social media channels: Instagram, Facebook, Twitter, and LinkedIn.
