How do I transfer my medical records to a new doctor?

You request them. Washington law (RCW 70.02) gives patients the right to a copy of their own medical record, and most practices have a records release form on their website or patient portal. Sign the release, name the receiving practice, and the transfer is usually complete within two to four weeks. You do not need your current physician's approval, and you do not need to explain why you are leaving. At Kosmos we send the request on your behalf once you join.

Do I still need health insurance if I join a concierge practice?

Yes. A concierge membership covers the primary care relationship, not hospital care, surgery, specialists, imaging performed elsewhere, or prescriptions. Keep your plan. Many Kosmos members pair membership with a high-deductible plan, since the routine care they use most is already covered by the membership.

What happens to my prescriptions when I switch doctors?

Nothing lapses if you sequence it correctly. Ask your current practice for refills that carry you through the transition, typically 60 to 90 days, before your last visit. Your new physician reviews the full medication list at the first visit and takes over refills from there. Bring the actual bottles or a current list to that visit rather than relying on the records transfer.

When is the best time of year to switch to a concierge doctor?

There is no wrong month, but two dates are worth checking. If you have already met a large share of your insurance deductible this year, finishing any planned specialist work or imaging before January can save money. And if you have prepaid an annual fee at another concierge practice, ask about the refund terms before you give notice.

Switching to a Concierge Doctor in Seattle: How It Works

The decision usually takes people a few weeks. The logistics take about two to four, they run in parallel, and almost none of it requires anything from your current doctor.

Here is the whole process, in the order it actually happens.

You do not need permission to leave

This is the part that stops people, and it should not. You are not asking your current physician for approval. Washington law (RCW 70.02) and federal privacy rules give you the right to a copy of your own record, and under those federal rules a practice cannot withhold it because you are leaving or because you owe money for past care. A practice may charge a reasonable fee for copying.

You do not owe anyone an explanation either. If you have a long relationship with your physician and want to tell them, that is a courtesy, not a requirement.

What happens to your records

Records move on a signed release. You sign one form naming the practice that should receive your file, and the sending practice transmits it. Two to four weeks is typical. Older paper records and imaging from outside systems can take longer.

Two practical notes:

Ask for imaging separately. Radiology reports usually travel with the chart. The actual images often live with the imaging center rather than the clinic and need their own request. If you have had a CT, MRI, or coronary calcium score in the past few years, ask for the images on disc or a portal link.
Bring your own summary to the first visit. A one-page list of your conditions, surgeries, medications with doses, allergies, and family history is more useful in the first hour than a 400-page chart export. Your physician will read the chart. The summary is what makes the first conversation productive.

At Kosmos, we send the records request for you once you join, and we review what arrives before your first full visit rather than during it.

What happens to your insurance

Keep it. This is the most common misunderstanding about concierge medicine, and it is worth stating plainly: a membership is not insurance and does not replace it.

Your plan continues to cover specialists, imaging, labs sent out to a reference lab, emergency care, hospitalization, surgery, and prescriptions. What changes is only the primary care relationship.

The practical question is what your practice does with your insurance card after you join:

Some concierge practices charge a membership fee and bill your insurance for office visits. Your total annual cost is the fee plus your usual copays and deductible.
Kosmos does not bill insurance for primary care. There are no copays, no per-visit charges, and no surprise bills from us. The tradeoff is that the membership is not offset by insurance reimbursement.

Depending on your plan, some costs may be eligible for an HSA or FSA. One update worth knowing: beginning January 1, 2026, the IRS allows people in certain direct primary care arrangements to contribute to an HSA and to pay those periodic fees with HSA funds. That provision is written for direct primary care and carries fee caps of $150 a month for one person and $300 for more than one, so a concierge membership at our price point does not qualify. If someone tells you otherwise, ask them to show you the rule.

If you are on Medicare

Ask early, because the answer varies by practice and it is not intuitive.

Kosmos does not bill insurance for primary care and has opted out of Medicare. Medicare continues to cover your specialists, imaging, hospital care, and prescriptions exactly as before. What it does not do is pay for your primary care visits with us.

Other concierge practices remain Medicare participating and bill it normally alongside the membership fee. Neither approach is wrong. They are different arrangements, and you should know which one you are signing.

Prescriptions and continuity

Sequence this and nothing lapses. Before your last visit at your current practice, ask for refills that carry you 60 to 90 days out. Your new physician reviews the full list at the first visit and takes it over from there.

If you take a controlled substance, raise it in the intro call rather than after you join. Transfer rules are stricter, and a good practice will tell you upfront how they handle it.

Timing

There is no wrong month to switch. Two dates are worth a moment of arithmetic:

Your deductible year. If you have already met most of your deductible, any planned specialist visit, procedure, or imaging is cheaper before it resets. That is unrelated to the membership itself, but it can be worth a few thousand dollars.

Any fee you have already paid. If you are leaving another concierge or direct primary care practice, check the refund terms on the unused portion before you give notice. Most prorate. Some do not.

What the first 90 days look like at Kosmos

A call first. Thirty minutes with one of our physicians. We talk about your health and whether this is a fit.
Enrollment and records. You sign the membership agreement, we request your records, and you get your physician’s direct number that day.
The first full visit. Ninety minutes or more, and mostly conversation. History, goals, what has been missed, what worries you.
The annual assessment. Structured around our eight focus areas, from metabolic health to advanced cardiovascular and cancer screening. For Optimal Care members this includes the full diagnostics program.
A plan you can actually read. What we found, what it means, what we are doing about it, and what happens next year.

Before you give notice anywhere

Before you cancel anything, put the practice you are joining through the questions that actually separate concierge practices: panel size, what the fee covers, whether insurance is still billed, and who answers when your physician is away.

Kosmos limits each physician to 100 families, and there are three of us, so coverage is a colleague who can see your chart rather than an answering service. You can read how the practice works, see what every Seattle practice charges, or schedule a call.