How Concierge Medicine Works with Insurance | Ask Dr. Tommy
ABOUT DR. TOMMY
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How Concierge Medicine Works with Insurance
Tommy McElroy, MD
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ONE OF THE QUESTIONS I GET MOST OFTEN IS ‘DOES THIS SATISFY THE OBAMACARE INSURANCE REQUIREMENT?’ The answer is ‘No.’ I always advocate that patients have insurance that fits their needs. In my opinion, insurance should be used for things that are a) Rare b) Expensive c) Unpredictable. That being said, finding a true ‘catastrophic’ health plan is impossible nowadays without paying a government-imposed penalty. One alternative to ACA-compliant insurance is a health sharing ministry plan. For more information about non-insurance choices for patients, see my ‘Patients’ section.

Back to the question about how we as membership medicine physicians work with insurance, we work with patients to use their insurance plan to their benefit. Some patients have insurance that covers all labs and imaging and some don’t. For those that do have coverage, we draw labs and order tests and let their insurance pay. For those without coverage, we provide wholesale pricing on labs and medication while giving them access to cash prices on imaging that have been pre-negotiated with our practice.

So for patients who have insurance or for patients who do not have insurance, our concierge medicine membership works equally well.


Dr. Tommy McElroy is a concierge medicine physician in Wesley Chapel, Florida. He is the founder of Echelon-Health.

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