Physician Retainer Fee: FSA Eligibility

Physician Retainer Fee: reimbursement is not eligible with a Flexible Savings Account (FSA)
A physician retainer fee is not required for treatment prevention or diagnosis of a medical condition and therefore not eligible. However, medical treatments actually performed by the physician are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (LPFSA).

What is a physician retainer fee?

A physician retainer fee is a prerequisite for a type of medical care called concierge medicine where patients will pay an out-of-pocket fee to become a patient of a medical professional with a small, established clientele. In most cases, these are physicians who have made the determination that they will no longer accept insurance payments for their services, and as opposed to having their insurance cover the cost of care, patients will instead pay a retainer for the doctor's services. While consumer-driven healthcare accounts do not cover the initial expense of concierge fees, any medical services paid for at these offices would be covered (Modern Healthcare).

What are the benefits of concierge medicine?

Concierge medicine has become increasingly popular as a direct result of the structure of the American healthcare system. Doctors are paid to make diagnoses and perform procedures on patients, but they are not paid for the time they spend with patients or for their efforts to coordinate care. Additionally, doctors are forced to employ individuals to process insurance reimbursements, billing and other services, which can be an onerous process and may hurt their financial bottom line overall. While some boutique practices may reimburse through insurance on a limited basis, the vast majority will not work with insurance at all.

As a result, many doctors have opted to embrace physician retainer fees as a means of simplifying the healthcare process, while in turn offering their patients an improved standard of care (i.e. longer office visits, 24-hour service etc.). However, under this format, doctors are left to determine what exactly their physician retainer fees will cover. For instance, some concierge doctors will charge an annual fee for their services and patients will also have to pay for in-office visits, while other physicians will have their retainers cover all in-office care as well. It's vital for prospective patients to shop around to find the best combination of services and affordability for the cost of an annual retainer (The Health Journal).