Concierge Medicine and your HSA

What is Concierge Medicine?

Concierge medicine refers to the relationship between a primary care physician and a patient in which the patient has to pay an annual retainer fee. This is also commonly known as “Direct Primary Care”, or DPC. 

Patients of concierge practices enjoy greater access to their physicians, preventive services, personalized healthcare, and educational wellness. The concierge business method offers patients perks like 24-hour access to a doctor, quick responses, appointments without wait time, answers to questions and treatment via e-mail, and even house calls as defined under their concierge agreement.

While the consumer-driven healthcare accounts like HSAs do not cover the initial expense of concierge fees, they cover any medical services fee paid for at the offices.

Using HSAs to Cover Concierge Medicine Cost

When it comes to covering the annual fee for this service, people who have HSA plans often use the funds from their HSA to pay for it.  How?

Funds from your HSA can be used to reimburse your cost of concierge medical services. You can use your HSA funds tax-free to pay for individual health care services that you receive from your concierge physician, but you cannot pay your full annual concierge medicine service fee with your HSA funds without penalty. Here’s an outline to help make things a little more clear:

• • Let’s assume you paid $2,500 for your concierge or DPC  membership.
  • You used your membership for $1,000 during that year in medical services that were not reimbursed by insurance, but were HSA-qualified.
  • If your physician provides an invoice that shows the actual cost of qualified medical expenses received under your concierge agreement, then you can reimburse yourself for that $1,000 from your HSA.
  • However, you cannot reimburse yourself from your HSA for concierge services that are more than your annual concierge fee.

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Qualification for Reimbursement

There are exceptions and qualifications, of course. You can reimburse your HSA or send payment to the medical concierge directly from your HSA regardless of the criterion of the medical expense. If you reimburse yourself for concierge services received, ensure you keep detailed records in case of an IRS audit of your HSA.

If you do not have health insurance, but are a member of a health sharing ministry instead, you may be able to pay the concierge fees from your HSA, since you technically do not have another “plan” (health sharing plans are not considered to be health plans). 

For medical services for which you are charged, make sure your doctor provides an itemized bill so you can use the HSA for qualifying expenses.

If you do use your HSA to pay for your treatments or concierge medicine fees, you can reimburse yourself from your HSA or send payment to the medical concierge directly from your HSA. If you reimburse yourself for concierge services received, ensure you keep detailed records in case of an IRS audit of your HSA.

You can go here to see a complete list of HSA-qualified expenses.

Final Thoughts on Concierge Medicine

Whether to choose concierge medicine or not is an entirely personal decision. Much of it depends on whether you are happy with your current level of care through your primary care provider. You may also be limited by your geographic location; while this model of medicine is becoming more popular and therefore more available, you may not be able to find a concierge practitioner where you live.

There is growing political pressure to allow fees for fee-based concierge DPC charges to be paid for from health savings accounts. This would be a tremendous benefit for the growing number of consumers who are receiving medical care via this more personalized service.

Since my personal goal is to help you save money on your health care needs, including on both premiums and out-of-pocket expenses, I will say that there is no reason why you should not choose concierge medicine if it is available to you. The overall expenses, including the annual fee, are not likely to be more than you are currently paying, and in many cases may even be less. This is especially true if your doctor offers discounted services for cash payments.

If you would like help deciding on your best health insurance options, schedule an appointment to speak with one of our Personal Benefits Managers.

Here are some additional articles on HSA insurance: Complete Guide to Direct Primary Care (DPC) | Health Savings Accounts Are Built for Alternative Therapies | How To Fix The Most Common HSA Mistakes

Here are some additional pages related to this article: DPC Direct Healthshare | How to Maximize your HSA | Health Savings Accounts Just Got Stronger

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