What concierge medicine actually costs, and whether it is worth it.
Concierge pricing, explained plainly.
By Vikram Sharma, MD, board-certified internal medicine.
Pricing in this category can be hard to find published up front, which makes the whole category hard to judge. So here is the straight answer to the question on your mind: what does it cost, what do you get, and is it worth the money?
First, where I am coming from. I am genuinely passionate about practicing this way. What I love most is the time it gives me with the people I care for: time to learn who you are as a person, not just as a chart, and to be a steady presence for your questions and the things life brings.
I want to be the doctor you trust enough to call, with the time to actually listen. That is what concierge medicine makes possible, and in the end the price is the price of that time.
The short answer on price.
It can range a lot. At the lower end, some membership practices run in the low hundreds of dollars a month. At the higher end, some published Bay Area concierge rates exceed a thousand dollars a month.
Many practices do not publish rates at all, so the real range is wider than what is openly advertised.
The price you pay buys one thing above all: the doctor's time and access. Everything else follows from that.
What you are actually paying for.
In the typical insurance-based model, a primary-care panel can be large, often in the low thousands of patients, and individual practices vary. Larger panels tend to show up as shorter visits, longer waits for an appointment, and slower replies to messages.
A concierge practice deliberately caps its panel at a fraction of that number. Fewer patients per physician is the entire product. When you pay a membership fee, you are buying your share of a much smaller panel, which is what makes the following possible with the Concierge Membership:
- Hour-long visits
- Same-day or next-day appointments instead of multi-week waits
- Direct access to your physician by phone or secure message
- A doctor who has the time to actually know your history
This is what primary care looked like before panels grew to their current size.
What the fee usually includes, and what it does not.
This is where transparency matters, because "included" means different things at different practices. At a well-run membership practice, the monthly fee generally covers the primary care itself: office visits, messaging access, care coordination, and the physician's time.
It typically does not include things that are billed by outside parties, such as:
- Laboratory tests
- Prescription medications, filled at the pharmacy
- Imaging, specialist visits, and any hospital care
The hidden cost of "free" insurance care.
It is fair to ask why anyone would pay out of pocket when they already have insurance. The honest reframe is that insurance-based primary care is not free; the cost is just paid in a different currency.
It could be paid in three-week waits, in fifteen-minute visits, in time taken off work for appointments, in urgent-care trips when same-day access to your own doctor is not available, and in the separate bills that pile up when weight management, hormone care, and primary care are each handled by a different clinic.
Membership medicine rolls much of that back into one relationship and one predictable number. Whether that trade is worth it depends entirely on how much the current system is actually costing you.
How Vikram Sharma, M.D. prices it.
Pricing should be easy to find, so here is ours in plain text. Vikram Sharma, M.D. is a direct-pay concierge primary-care practice in the East Bay.
The Concierge Membership is $499 per month at the founding rate, locked for as long as you remain a member, for the first ten members, with no initiation fee (the rate rises after the founding cohort), and what you pay up front is credited toward your first month. No co-pays, no per-visit charges, and membership is month-to-month.
The Concierge Membership includes comprehensive primary care, unlimited hour-long visits, direct secure messaging, and several services that are often handled at separate clinics: medical weight management with GLP-1 therapy and hormone and thyroid care, when clinically appropriate, all under one physician.
You can see the full list on the membership page, and the broader cost-and-insurance picture on Concierge Medicine Explained.
Prefer to start focused? The Metabolic & Hormone Membership covers physician-managed GLP-1 weight loss and hormone therapy, with labs, monitoring, and direct messaging, at $199 per month founding for the first ten members, locked for as long as you remain a member (the rate rises after), with no initiation fee; what you pay up front is credited toward your first month.
Same physician, same standards, scoped to metabolic and hormone care. Real medication cost ranges, with and without insurance, are published on the Good Faith Estimate page.
So, is it worth it?
The honest answer is that it depends. It depends on what you value, and on how well your current care is actually fitting your needs. If your health is simple, your current doctor is easy to reach, and you rarely think about your care, you may not need this.
If you are managing chronic conditions, juggling multiple clinics, tired of waiting weeks to be seen, or you want one physician who handles weight, hormones, and primary care together, the value tends to be obvious quickly.
The most useful step is to speak with your physician about whether concierge medicine is the right fit for your situation.
Related reading: concierge vs traditional primary care, what actually changes.