Individual Health Program

Frequently Asked Questions

Q. What is private health care?

A. Private health care, also called concierge or boutique medicine, represents a higher standard of health services for individuals who want more extensive, personalized health and wellness care from a personal physician through the payment of an annual retainer fee.

 

Q. Does my insurance cover the annual Members.MD fee?

A. Because there are no direct medical services involved in the membership fee, traditional health plans typically will not cover the annual membership fee. However, if you belong to an approved Employer Section 125 plan, you may be able to use funds from your flexible spending account, medical savings account, health reimbursement account or health savings account. Please check with your employer to confirm eligibility.

 

Q. What is included in the fee?

A. The annual membership fee provides you with your own private physician who is available by phone, email, text or video conference; same-to-next-day appointment availability at the convenience of your schedule; a personal health advocate who helps you set and achieve your wellness goals; as well as many other benefits. The annual fee does not include direct medical services.

 

Q. Are payment plans available?

A. Yes. Payment may be made annually, semi-annually or monthly.

 

Q. What’s the difference between the program options?

A. Members.MD programs offer similar benefits relative to physician access and time, but the Premium Care program includes care management in other settings such as hospitals, emergency rooms and rehab facilities. It also provides an option for in-home and at-work visits and additional support with outside referral services among other features.

 

Q. Is there a minimum or maximum age to participate?

A. There is no maximum age to participate. Some Members.MD physicians do not provide care to pediatric patients; however, this is determined on a case-by-case basis.

 

Q. How do I select my physician?

A. Members.MD will provide names and background information on available physicians and help schedule a personal appointment to interview and select your physician. Or, if you prefer, Members.MD can assign a physician on your behalf. Click here to view the physician locations.

 

Q. Do I need to notify my current physician if I enroll?

A. Members.MD will contact your current physician and with your permission, request copies of your health records.

 

Q. What if I prefer to keep my OB/GYN?

A. Your Members.MD physician specializes in primary care. Some women elect to also maintain an OB/GYN physician relationship.

 

Q. How does my health insurance work with my physician services?

A. Your insurance will be billed for all direct medical care services and tests you receive from your physician. You will be responsible for your usual deductibles and co-pays.

 

Q. Is Medicare accepted?

A. Yes, your direct medical services will be billed to Medicare by your physician.

 

Q. Are there restrictions on which hospitals or other specialists I may use?

A. No, there are no restrictions. Your physician may not have admitting privileges at all hospitals and he/she will explain how this will be handled if you elect to use one of these hospitals.

 

Q. Can I pause my membership if I go out of the country?

A. You may pause your membership at any time with a 30-day written notice. However, most members elect to maintain their Members.MD membership when they are away from home – even during national or international travel – so they have a dedicated physician available in the event of illness or an emergency.

 

Q. Can I upgrade my membership option?

A. Yes, you are eligible to upgrade your membership at any time. If you upgrade to a higher membership level, you are required to stay at that level for 12 months. Contact the Members.MD office at 402-934-6283 for more information on how this works.

 

Q. Can I add family members at a later time?

A. Yes, you are welcome to add any eligible family members at any time.

 

Q. Is there a discount for my spouse?

A. Discounts may be available for spouses and dependents. Contact the Members.MD office for more information.

 

Q. Can I withdraw from the program?

A. Members may withdraw from the program with a 30-day written notice.

 

Q. Do I need to find a new doctor if I don’t join Members.MD?

A. If you elect not to join Members.MD or to see a clinician at the former clinic, your physician will provide you with a list of other primary care physicians in your area.

 

Q. Who gets the membership fee?

A. Members.MD physicians limit their patient base to 400 patients. Therefore, the majority of the membership fee goes directly to your Members.MD-affiliated physician. A small portion of the fee goes to Members.MD for operational support.

 

Q. How long has Members.MD been around?

A. Members.MD was founded in 2010 and serves more than 500 members.

 

Q. How many Members.MD practices are there?

A. There are four Members.MD-affiliated physicians who practice in the Omaha and Council Bluffs metro area. Click here to view the practice locations.