How this works
Not alternatives. You want both.
They cover different things. You will almost certainly want both.
Concierge medicine works alongside your insurance, not instead of it. The membership fee is paid directly to the practice and covers your relationship with your physician. Your insurance continues to cover care delivered elsewhere: specialists, imaging, hospital stays and prescriptions. Insurance does not reimburse the membership fee.
Where we stand
The position, stated plainly.
The membership fee covers the enhanced primary-care relationship and services provided by My Choice Primary Care. It does not replace health insurance. Patients should maintain insurance for medications, laboratory testing, imaging, specialists, hospitalization, and other outside medical services.
Insurance and Medicare do not cover the membership fee. The fee is paid directly to My Choice Primary Care and is not billed to insurance, and Dr. Sisodia has formally opted out of Medicare.
Yes, you still need insurance. We do not participate in any insurance networks, including HMOs, Tricare Prime, or Medicaid. Your membership covers your care with Dr. Sisodia, and it does not pay for care delivered anywhere else. You will need insurance for emergency care, routine bloodwork and laboratory tests, imaging, hospital stays, surgery, and specialist visits and procedures.
The split
What each one pays for.
Membership and insurance cover different things. One does not replace the other.
| Your membership | Your insurance | |
|---|---|---|
| Primary care visits | Covered. Extended and unhurried, same-day or next-day. | Not used for these. |
| Direct access to your physician | Covered. Phone, text or video, directly. | Not a benefit insurance provides. |
| Specialists | Coordination is covered. The specialist is not. | Covers the specialist visit under your plan. |
| Imaging and labs | Ordering and interpretation are covered. | Covers the imaging or lab itself under your plan. |
| Hospital care | Coordination and continuity are covered. | Covers the hospital stay under your plan. |
| Prescriptions | Prescribing and review are covered. | Covers the medication under your plan. |
Side by side
Against a traditional practice.
The structural differences, not the marketing ones.
| My Choice Primary Care | Traditional insurance-based practice | |
|---|---|---|
| How the practice is paid | One membership fee, paid directly to the practice, set by a stated formula. | Per visit and per service, billed to your plan, with copays and deductibles. |
| Panel size | Capped at 150 patients. | Not capped by the payment model. |
| What the fee buys | Your relationship with Dr. Sisodia: time, direct access and coordination. | The billable visit or service itself. |
What we commit to
What the cap is actually for.
These are ours to promise. We are not claiming another practice cannot also do them.
- Visits are extended and not cut short.
- Same-day or next-day appointments when you need one.
- You reach Dr. Sisodia directly by phone, text or video.
- One physician who already knows your history.
- Referrals, imaging and specialty labs are coordinated by the practice rather than handed to you as a number to call.
The other side
The honest caveat.
Every difference above is real, and none of it makes this the right choice for everyone.
Everything above is a real structural difference, and none of it makes concierge care the right answer for everyone. You are adding a cost that insurance will not reimburse. If you rarely see a physician and have no ongoing conditions, that cost may not return its value. We would rather you weigh that properly than join and regret it.
Common questions
Insurance and Medicare.
- Does insurance or Medicare cover the membership fee?
- Insurance and Medicare do not cover the membership fee. The fee is paid directly to My Choice Primary Care and is not billed to insurance, and Dr. Sisodia has formally opted out of Medicare.
- Do I still need health insurance?
- Yes, you still need insurance. We do not participate in any insurance networks, including HMOs, Tricare Prime, or Medicaid. Your membership covers your care with Dr. Sisodia, and it does not pay for care delivered anywhere else. You will need insurance for emergency care, routine bloodwork and laboratory tests, imaging, hospital stays, surgery, and specialist visits and procedures.
- What is not included in membership?
- Billed separately and not part of membership: medications, laboratory testing performed by outside laboratories, imaging, specialist care, hospital care, vaccines, and other services provided by outside facilities or clinicians.
- Does Dr. Sisodia have hospital admitting privileges?
- No. Dr. Sisodia does not hold admitting privileges at any hospital, so if you are admitted, the hospital's physicians direct your care there. She may make a courtesy hospital visit when feasible, but she does not serve as the admitting or attending physician.
Next step
Still weighing the trade?
Half an hour with the physician answers more than any page.