Ask Lemmy

TL;DR: I don't really know.

My health care insurance does this too. I save some $50/yr to agree to a call from an RN to help me with my health condition(s). A coworker who formerly worked in health insurance told me that while they also help you to navigate the health insurance system and/or find cheaper care or whatever, you're actully still talking to your health insurance company and not your doctor and so anything that you say is now on your health insurance record. This can be used to deny future coverage for an existing condition, dissuade you from pursuing more expensive (for them) medical treatments or to raise your company's rates for certain ailments (for example, everyone at your company smokes, they'll drop coverage for asthma).

The health insurance company doesn't know all of your ailments simply based on the billing codes. You are protected by HIPPA. Your health insurance company can ask you anything and anything you say to them is not necessarily covered by HIPPA.

Reading this question and these comments, the US healthcare system must be so fucking exhausting.

"Are these scam calls or will I lose my coverage if I ignore them? I literally can't tell."

I thought a 'concierge program' was similar to OneMedical. You pay an annual fee, have a PCP, but the PCP doesn't typically do much besides refer you to specialists, give advice, or prescribe meds.

A concierge service can be immensely helpful. My company got bought by a giant tech company in 2019, when it happened, a) I was 4 weeks into a 6 week open heart surgery recovery and b) they changed my insurance causing me to lose my existing hospital and all my current doctors.

The concierge set me up with a new hospital and new doctors. When I started having post surgical complications that would have killed me, and the new hospital told me I'd have to wait 3 months to see someone, the concierge got that time cut down to 2 weeks.

I mean, I still almost died, and wouldn't have if I had been able to keep my existing insurance, but the concierge took care of things that I was in no shape to deal with.

Think of them like the medical version of a hotel concierge. "Hey, can you arrange for a cab to meet me here at 2:45 PM?"

"Certainly sir."

Likely it's a 3rd party that works with your insurance company to offer some bs where you pay more and can talk to a nurse practitioner on the phone whenever you want.

I got one of these calls. I looked on their site snd they had like 30 nurse practitioners and 1 or 2 actual doctors. I bet 99.99999% of the time you get connected to a NP and not a MD.

For BlueCross/BlueShield it's "pay more to get priority access and continuity of care".

Seriously.

My mom has it, we decided it was worth the premium bump because she's in Palm Springs and it's a consolidated health system there, everything from Medicaid to Concierge BlueCross is in the same building. I'm not sure if it's totally necessary but they do treat her really well.

I can't answer why you're getting calls, but I'd be suspicious.

It's where your primary care physician goes independent and stops accepting insurance. You pay them a flat fee a couple of times a year, and get their service for free. That is, you're obviously paying them whether you use them or not, but you don't pay them every time you see them.

You still need insurance, to cover things like specialists, and many tests the doctor performs - blood work, etc - can still be billed to insurance. But you go to a flat fee for your doctor.

My wife and I did it because our primary care physician, who we've been with for years and like, went concierge; we decided to stay with her despite it costing more than to switch to a different doctor.

Many things changed, mostly for the better.

• It is more expensive
• We get appointments with her often the same day - no more scheduling three weeks out
• We have an instant messaging app, and message her any time, and get a response within minutes up to a half hour. I've messaged her on the weekend and gotten an immediate response. She's not the only one who answers - her PAs field some stuff, like appointments, but getting the immediate response is fantastic
• We no longer worry about co-pay or getting bills from her. Unless there's lab work, all we pay is the bi-yearly fee. The emotional value of feeling free to contact her any time about anything can not be undervalued
• She loves it because, apparently, working in a clinic is hell for physicians. Shitty records systems, slow information responses, bureaucracy, crammed scheduling. She's happier.
• I have yet to have to wait to see her. If I have an appointment, any time of the day, I show up and she's ready. No sitting in the waiting room for a half hour.
• We're able to hold cheaper insurance, because we're paying for the GP out of pocket.

There is really the only one downside: insurance does not cover concierge, and it is not cheap. It's within reason for middle class, but it'd be utterly unaffordable for lower or lower-middle class. It's totally entitled. OTOH, if we had a single payer universal healthcare system, or if every provider were concierge, healthcare would be cheaper all around and maybe it'd be affordable.

Anyway, we did it because we followed a doctor. I don't know that I'd jump into it with a provider I didn't know. In our doctor's case, she only offered it to her existing patients and doesn't take on new ones (or, not often), and keeps her work load more manageable; I'd expect this to be common.

If insurance is trying to get you to do this, there's an angle and I'd be suspicious. Either because they have to pay less (because concierge fees aren't paid by insurance); or some company has figured out a way to "give you insurance" where you pay them and they pay the concierge fee, in which case they're just a middleman skimming money and you're paying more.

We are extremely happy with our concierge service, but we love our doctor, we can afford it, and it's been a massively better experience for us. But that's us. YMMV.

Normally these are optional wellness features. Insurance companies will bug you to download a meditation app or go get a checkup because preventative medicine is cheaper.

These things are generally safe to ignore, if you are really concerned though the best course of action would be to call the number on your insurance card and ask them if anything is up. If you owe them money or need to do something they won’t be shy about it.

Concierge service is usually separate from traditional health insurance. Idk what it means in the context of an existing plan.

Do they specify “I am from x company” or do they say “I am calling about your health insurance”?

Its for people that require several specialists for their health coverage. For example cancer patients who have surgeons, screenings, treatments all thru seperate departments or facilities all together. The concierge helps coordinate your shit and helps keep everyone in communication and keeps you on schedule.

Doesnt have to be cancer tho. They can be helpful for example my case where I'm seeing psych for counseling, psych MD for prescribing, endocrinologist for type 1 diabetes, primary physician cuz its req. So I've used them to keep all that shit in line.

If you are getting calls about this, it means you are costing them money. They want you to use their nurses and doctors through telehealth visits first to dissuade you from more expensive treatment like er visits.