In the interest of full disclosure, I have been a subscriber to personalized primary care experience provider, MDVIP, for the past eight years. I am obviously a satisfied user, and frequently recommend the service to others. When I mention that I am a subscriber, the question posed in the title of this article is usually the first reaction. My patented response is, “The question you should be asking is, “Is your regular health insurance worth the money?”
As a beginning point of reference, my MDVIP subscription costs $2,250 per year. There is a $30 co pay for each office visit. According to a recent Wall Stret Journal article, the average annual cost for a family health insurance plan is $27,000. As a small business owner in Hawaii, the 2026 premium for my family HMSA PPO will be more than $33,000. There is an additional $12 office visit fee and a10 20% co pay. The maximum annual out of pocket expense is capped at $2,500. The plan includes medical, dental, and vision care.
Of course, comparing price is meaningless, as these respective charges pay for vastly different services. MDVIP effectively replaces the primary care physician that is included in my HMSA PPO. My medical insurance also covers the cost of specialists, hospital care, and treatments including expensive treatments and surgeries for serious medical conditions. Comprehensive health insurance is indispensable, so comparing value requires a decidedly more circumspect approach.
The Value of a Private Primary Care Physician
The impetus to pay an extra $2,250 per year for a private primary care physician arose from my experience with the primary care physician who was included in my PPO coverage. The PCP was bright, experienced, and caring. He was also desperately overworked. I saw him twice per year for 15 minutes at most. I believe he was quadruple booked. He had thousands of patients assigned to him by HMSA. Visits needed to be scheduled months in advance. Each visit consisted of a short summary of my bloodwork. Symptoms could be referred to a specialist, but there was precious little time for meaningful prevention.
In contrast, most MDVIP doctors have fewer than 600 patients. My primary care physician, Dr. Judy, meets with me four times per year including one comprehensive exam done in conjunction with Cleveland Clinic. Each visit lasts 45 minutes to an hour and is a thorough one on one wellness review. Scores of biometric data points are tracked quarter by quarter and year by year.
The improvements in my health are tangible and quantifiable, and I have access to a range of tests, including body scans and specialized blood tests that are entirely aimed at prevention and early detection. For instance, a Prenuvo body scan I underwent in 2024 indicated a possible cyst or tumor on my pancreas. A subsequent MRI revealed two small cysts that Dr. Judy will monitor each year. In all likelihood, they are benign, but if they are not, the outcomes from early detection are far, far better than waiting until they become symptomatic.
The difference in the primary care physician experience has been vast. My health is definitely better and I feel I am doing everything possible to nip potentially catastrophic issues in the bud.
The Problem with the Health Insurance Industry
As I mentioned above, my HMSA primary care physician was not the problem. Like me, he is a victim of a health care system that is managed by the insurance companies. To further support this view, I have been experiencing chronic lower back pain for a number of years. The Prenuvo body scan indicated a bulging disk, so Dr Judy referred me to an HMSA neurologist. After a three month wait for an appointment, he agreed that there is a problem. His initial thought was that I have degenerative disk that is impinging on a nerve, and that fusion surgery was the likely solution. He requested an MRI to confirm this. HMSA rejected his request twice and advised that I must first undergo months of physical therapy and provide all the receipts before they would authorize an MRI. I asked the neurologist if I was correct in my perception that HMSA was overriding his recommendation and prescribing a remedy without knowing what the problem is. His signed and replied, “Unfortunately, that is correct.”
Last month, I flew to Thailand for a spinal MRI at Bumrungrad International Hospital for a fraction of the cost of an MRI in the U.S. The cost was only a slightly more than my co pay would have been for the MRI in the U.S. The MRI confirmed what my Hawaii neurologist had suspected and his Thai counterpart suggested that the PT HMSA prescribed would have been useless and potentially even harmful. It is experiences like this that lead me to conclude that I am not getting my money’s worth from my health insurance.
Am I the Problem?
A commonly cited objection to concierge health care is that it benefits the “worried well” at the expense of the truly sick. Critics often suggest that the cost of following up on the high instances of false positives that arise from various medical screening provided through concierge healthcare strains the healthcare system. It is true that because I have the resources to pay for this extra care, I am able to get care that regular health care insurance participants cannot, but am I really the problem? I am paying more than $33,000 per year and sure don’t feel like I am getting anything close to $33,000 of value.
Wouldn’t it be better if we had a health insurance system that allows everyone to have access to preventive care? From a financial perspective, it seems intuitive that the cost of treating maladies such as strokes, heart attacks, and advanced cancers costs much, much more than the cost of preventing these maladies through early detection. I argue that health insurance companies are the problem, not doctors or the patients.
How is this Relevant to Financial Planning?
To the extent that medical related expenses are an important consideration in retirement income sustainability analysis, discussions such as this are highly relevant to retirement planning. Most planners are familiar with the concept of the “retirement spending smile” the graph that shows how retirement spending tends to be high in the early years of retirement as retirees travel and celebrate their lives, then falls as physical age related infirmities set in, and then rises again as the cost of long term custodial care kicks in. To the extent that we may be able to help our clients avoid some of these later life expenses by living healthier lives and focusing more on prevention, I submit that concierge health care is a topic worth raising. As the adage goes, “An ounce of prevention is worth a pound of cure.”
