MD², MDVIP, and Kosmos: How Seattle's Concierge Models Differ

The short answer: MD² caps each physician at 50 families and does not publish a price. MDVIP does not publish one price at all, because the fee is set by each affiliated physician. Kosmos publishes both of its fees, $575 and $1,250 a month, and caps each physician at 100 families.

Those three sentences describe three different businesses, and there is a fourth model in the Seattle market as well. Understanding which one you are talking to matters more than comparing the numbers, because the numbers are not measuring the same thing.

Model one: ultra-concierge

MD² was founded in Seattle in 1996 and is generally credited with starting the category. Its model is the most extreme version of the idea: its Seattle page states that “you are 1 of just 50 families who retain the services of a personal physician.”

MD² does not publish a fee. The same page says the annual retainer varies based on family configuration and asks you to call. What exists publicly is indirect: MD²’s own guide to concierge pricing describes ultra-personalized care as a $15,000 to $40,000 a year category, and MD² hosts 2017 press coverage that put a membership at $25,000 a year.

What that buys is availability at a level almost no other model can match. At 50 families, a physician has room for essentially any request. Whether that is worth three to five times the price of a small-panel independent practice depends entirely on how you use a doctor.

Model two: the national network affiliate

MDVIP describes itself as the largest concierge network in the country. Its physicians are independent affiliates rather than employees, which is why its FAQ says “the annual fee for MDVIP-affiliated practices varies based on locale and physician” and sends you to look up a specific doctor.

The number worth reading carefully is the panel, and MDVIP publishes two versions of it. Its membership overview says affiliated physicians “typically care for 40% fewer patients relative to traditional practices.” A separate MDVIP page says affiliated doctors “limit their practices to around 600 patients.” Against a traditional panel of roughly 1,900 to 2,500 nationally, both describe a real reduction, and both are far larger than a panel of 100 families.

That is a real improvement over a standard practice, and the annual wellness exam is genuinely more thorough than what insurance normally reimburses. It is not the same product as a practice built around a panel in the low hundreds, and the fee reflects that: this tier generally sits in the low thousands per year rather than the tens of thousands.

There is a second thing to check with any network-affiliated practice: the membership fee usually sits on top of insurance billing rather than replacing it. You pay the fee, and the practice still bills your insurer for the visit.

Model three: the hybrid, and where Seattle prices sit

MedNorthwest, a Seattle concierge practice founded in 2002, is the local example of the hybrid, and one of the few that publishes plainly:

• $310 per month for the primary member
• $300 per month for a second household member
• $90 per month for children aged 11 to 20 whose parent is a patient

MedNorthwest also accepts and bills most major insurance plans, including Regence, Premera, Aetna, First Choice, and United HealthCare. So the membership fee covers the services insurance will not reimburse, and the medical care itself continues to run through your plan.

Seattle Premier Health is another local example. Its FAQ publishes a $335 monthly fee, its site says the program “operates on a membership basis” rather than billing each visit, and it states that each doctor limits their panel to “10% that of traditional primary care doctors.” Discover Health in Bellevue publishes no fee and describes its panels as “a few hundred patients.”

Model four: independent, small panel, no insurance billing

This is where Kosmos sits, and it is worth being direct about the tradeoff rather than presenting it as strictly better.

Each Kosmos physician holds a panel of 100 families. We do not bill insurance for primary care, and we have opted out of Medicare. Every member keeps their own health insurance for specialists, imaging, hospitalization, and prescriptions, and your physician coordinates all of it.

• Premium Care: $575 per month, or $6,900 a year. The complete primary care relationship: same-day or next-day appointments, 24/7 direct physician access, unhurried visits, and the eight-focus-area annual assessment.
• Optimal Care: $1,250 per month, or $15,000 a year. Everything above plus the full advanced diagnostics program: whole-body MRI, coronary CT angiography, VO2 max testing, DEXA body composition, continuous glucose monitoring, advanced cardiovascular and cancer screening, and genetics.
• Children of members, ages 15 to 29: $200 per month.

Not billing insurance is the reason the visits are long. Insurance billing is what creates the 15-minute appointment, because the practice has to run enough encounters per day to make the reimbursement math work. Removing it removes the pressure. It also means you are paying out of pocket for care your plan would have partially covered elsewhere, which is a real cost and worth naming.

The comparison that actually matters

Practice	Model	Published price	Panel
MD² (Seattle, Bellevue)	Ultra-concierge	None published	50 families per physician
MDVIP affiliates	National network, bills insurance	Published per physician, not centrally	”40% fewer patients”; elsewhere “around 600 patients”
MedNorthwest (Seattle)	Concierge, bills insurance	$310/mo member, $90/mo child 11-20	Not published
Seattle Premier Health	Concierge, membership basis	$335/mo, per its FAQ	”10% that of traditional” panels
Discover Health (Bellevue)	Concierge, bills insurance	None published	”A few hundred patients”
Kosmos Medical Group (Madison Park)	Concierge, no insurance billing	$575/mo and $1,250/mo	100 families per physician

Figures above are as published by each practice in August 2026. Prices change, so confirm directly.

Read that table by column, not by row. The price column is the least informative one: several practices do not publish a figure, and the figures that exist are not measuring identical services. The panel column tells you what the practice can physically do. The model column tells you what your bill will look like after the membership fee.

Three questions that settle it

1. How many patients or families does this physician carry? If the practice will not answer with a number, that is an answer.
2. After I pay the membership fee, does the practice still bill my insurance for the visit? This changes your annual cost materially, in both directions depending on your plan.
3. Is the advanced testing included, or referred out and billed separately? A $1,000 a year membership that refers you out for the imaging is not cheaper than a membership that includes it.

We are glad to answer all three for Kosmos on a call. If your priority is the lowest possible monthly cost with a physician who is simply more reachable than average, a hybrid practice or direct primary care is probably the right answer, and we will say so.

You can read how concierge medicine works at Kosmos, see prices and panel sizes for every Seattle practice, read our fuller breakdown of what concierge medicine costs in Seattle, see our full pricing, or schedule a 30-minute call with one of our physicians.