Concierge medicine is a primary care arrangement in which patients pay a membership fee for more access, while insurance usually still pays for covered visits.
Three counties, three income levels
| Area | Median household income | 65 and older | Source |
|---|---|---|---|
| San Francisco | $140,970 | 17.6% | [3] |
| San Mateo County | $158,855 | 19.4% | [5] |
| Santa Clara County | $164,281 | 16.3% | [4] |
At these incomes, a $4,000 membership is under 3% of the median household budget in each county. That helps explain why higher-fee models cluster here.
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Fees we could document
- One Medical: $199 a year for 24/7 messaging and video; office visits billed to insurance. A hybrid, not direct primary care [1].
- Sollis Health Signature: from $4,000 a year with on-site imaging and labs; regions include Northern California [2].
- MDVIP: says fees vary by locale and physician; pages we read elsewhere showed $2,250 to $2,930 [7][8][9].
We did not find a San Francisco practice posting its own retainer. Our concierge cost page tracks new examples.
Rules that affect your wallet
California has no direct primary care statute, per DPC Frontier [6]. Under IRS Notice 2026-5, HSA funds can pay DPC fees up to $150 a month per person only if the practice does not bill insurance [10]. Medicare will not pay concierge fees [11]; see Medicare and concierge care.
Testing-focused alternatives
Some Bay Area buyers want testing more than access. Compare executive physicals, longevity programs and functional medicine before paying a retainer. Check any physician on the Medical Board of California site [12].
Nearby concierge pages: Sacramento, Los Angeles, Santa Monica, Seattle. Overview: concierge medicine, find a concierge doctor.
Questions people ask
How much is concierge medicine in San Francisco?
What is the median income in the Bay Area?
Does California regulate direct primary care?
Not specifically. DPC Frontier reports that California has no statute written for direct primary care [6].
Is One Medical concierge medicine?
It is a hybrid: $199 a year buys messaging and video care, and office visits are billed to insurance [1].
Does Medicare pay concierge fees?
No. Medicare.gov says it does not cover concierge membership fees [11].
Can HSA money pay a San Francisco concierge fee?
IRS Notice 2026-5 allows HSA payment of direct primary care fees up to $150 a month for one person when the practice does not bill insurance separately [10].
Sources
12 cited
- Membership. One Medical, Oct 17, 2026.
- Membership. Sollis Health, Oct 17, 2026.
- QuickFacts: San Francisco city, California. U.S. Census Bureau, 2025.
- QuickFacts: Santa Clara County, California. U.S. Census Bureau, 2025.
- QuickFacts: San Mateo County, California. U.S. Census Bureau, 2025.
- California and direct primary care. DPC Frontier, 2024.
- What does MDVIP cost and what does my annual fee cover?. MDVIP, Oct 17, 2026.
- MDVIP physician page, Phoenix, AZ. MDVIP, Oct 17, 2026.
- MDVIP physician page, Bronxville, NY. MDVIP, Oct 17, 2026.
- Notice 2026-5: Health savings accounts and direct primary care. Internal Revenue Service, Dec 9, 2025.
- Concierge care. Medicare.gov (CMS), Oct 17, 2026.
- Medical Board of California. State of California, Oct 17, 2026.
This page is general information, not medical advice. Talk with a licensed clinician about your own care.