How to Compare Two Concierge Practices in Las Vegas Before You Choose One

What "concierge medicine" actually means

Concierge medicine is a membership model: you pay a recurring fee, usually billed annually or monthly, in exchange for things standard primary care often can't offer, like longer visits, same-day or next-day scheduling, direct phone or text access to a physician, and a smaller patient panel per doctor. The membership fee is separate from, not a replacement for, your health insurance. Your insurance (or Medicare) is still what gets billed for office visits, labs, and any medical services performed. The membership buys access and time, not care itself.

This matters in a city like Las Vegas where primary care access can be uneven. According to HRSA, large portions of Nevada are designated as Health Professional Shortage Areas for primary care, and the AAMC has projected a national shortfall of tens of thousands of primary care physicians over the next decade. Those are national and state-level workforce signals, not a guarantee about wait times at any one practice, but they help explain why concierge and direct-pay models have grown in markets like this one.

The different types of "concierge" you'll actually run into

Not all concierge practices work the same way, and the differences change what you're paying for.

1. Hybrid concierge. The practice still bills your insurance for covered services but charges a retainer for enhanced access, longer appointments, and amenities like wellness coordination. This is the most common model.

2. Direct primary care (fully retainer-based). No insurance billing at all for primary care visits. You pay a flat fee that covers most office-based care, and you still need separate insurance for labs, specialists, imaging, and hospital care.

3. Network-affiliated concierge programs. The individual physician or practice pays into a larger branded network that provides scheduling infrastructure, standardized annual wellness screening protocols, and a patient portal. Fees tend to be more standardized across doctors in the network, and the patient experience is more uniform from one affiliated doctor to the next. The tradeoff is less customization and sometimes less flexibility if you want a visit structure that falls outside the network's template.

4. Concierge tiers inside larger multi-specialty or hospital-affiliated groups. A subset of physicians in a bigger system offer a concierge option, often with the benefit of easier internal referrals to specialists in the same system, but the panel size and fee are usually set by the system rather than the individual doctor.

Before you compare two practices, figure out which category each one actually falls into. A hybrid practice and a fully direct-pay practice are not apples to apples even if both call themselves "concierge."

The honest downside of concierge care

No one selling a membership is going to lead with this list, so here it is plainly:

• You're paying twice. The membership fee is on top of your existing insurance premium, not instead of it. According to CMS, Medicare does not cover concierge or retainer fees; Medicare Part B still pays its share of covered medical services, but the access fee itself comes out of your pocket.
• It doesn't replace specialists, the ER, or hospital care. A concierge primary care relationship can help you get seen faster and get referrals coordinated, but it is not an in-house substitute for emergency or specialty care.
• Smaller panels cut both ways. A doctor with 300-600 patients instead of 2,000+ can offer more time per visit, but if that doctor retires, relocates, or leaves the network, your options for a fast replacement are narrower precisely because the panel was kept small.
• Not all membership fees are reimbursable. Some employers or HSA/FSA plans will not treat a concierge retainer as a qualified medical expense. Check with your plan administrator or a tax professional before assuming it's deductible.
• The fee is often not prorated cleanly. If you move, travel frequently, or only need a doctor a few times a year, you may be paying for access you rarely use.

Who this is probably not right for

If you're generally healthy, see a doctor once a year, and your current insurance-based primary care gets you seen within a week or two, a $1,500-$10,000+ a year membership (national range, concierge fees vary widely and there is no single standard local figure for Las Vegas) is hard to justify on cost alone. It also may not be the right fit if you're on a tight budget, rely primarily on Medicaid, or you move frequently and can't easily use a membership tied to one local practice. Concierge medicine tends to make the most sense for people managing multiple chronic conditions, people who have had trouble getting timely appointments, or people who place a high value on same-day access and longer visit times and can comfortably absorb the extra fixed cost.

How to actually compare two practices, side by side

Don't just compare membership prices. Use this checklist on both practices before deciding:

• What exactly is included in the fee? Ask for a written list: visit length, number of visits per year, phone/text/email access, wellness screenings, care coordination. Get specifics, not marketing language like "unlimited access."
• What is billed separately? Labs, imaging, specialist referrals, and procedures are almost always billed to insurance separately. Confirm this in writing.
• What is the panel size? Ask directly: how many patients does this doctor currently see under this model? A lower number generally means more time per visit, but verify it rather than assuming.
• Is this an independent practice or part of a larger network? Network-affiliated concierge programs often have more standardized protocols and support staff; independent concierge doctors may offer more personal continuity but less backup coverage if they're unavailable.
• What happens if the doctor leaves, retires, or the network changes? Ask about transition policies and whether any portion of an annual fee is refundable if the relationship ends mid-year.
• Can you do a trial period or month-to-month option before committing to an annual contract?
• Is the physician currently licensed and in good standing? You can verify this yourself through the Nevada State Board of Medical Examiners, which maintains license status and any disciplinary history for physicians practicing in the state.
• How does billing work with Medicare or your specific insurance plan? According to Medicare's own guidance, providers cannot require you to pay a retainer fee as a condition of receiving Medicare-covered services, though they can charge separately for non-covered concierge amenities. Ask the practice to explain this distinction for your specific plan.
• What does a typical visit actually look like? Ask for visit length and whether same-day appointments are truly same-day or "same-day if available."
• Get the total annual cost in writing, including any onboarding fee, family add-on costs, and what happens to pricing after year one.

A rough sense of cost, nationally

Published national data on concierge and direct primary care fees (tracked in part by organizations like KFF and various physician associations) shows a wide range, roughly from a few hundred dollars a year for leaner direct primary care models up to $10,000-$25,000 or more annually for higher-touch, lower-panel concierge programs. This is a national range, not a Las Vegas-specific figure, because membership pricing varies by practice, panel size, and what's included. Ask each practice for a complete, itemized quote rather than relying on an advertised starting price.

Bottom line

Comparing two concierge practices is really comparing two different packages of access, time, and service scope wrapped around the same basic insurance-billed medical care underneath. The fee amount matters less than what it actually buys and what it doesn't.

This article is educational information only, not medical advice, and it does not recommend any specific practice, doctor, or treatment. Talk to a licensed physician about your health needs, and verify any practice's licensing and billing practices directly before enrolling.

Related in this guide

• Concierge Medicine in Las Vegas: How Membership Practices Work and What They Cost
• What Concierge Medicine Costs in Las Vegas (And What You Actually Get)
• What Your First Year in a Las Vegas Concierge Practice Looks Like