Concierge Medicine in Seattle

Concierge medicine is a model of primary care in which you pay a membership fee directly to your physician rather than relying solely on insurance billing. In return, you receive same-day or next-day appointments, unhurried visits, 24/7 direct access to your doctor, and preventive care that a high-volume schedule does not leave room for. Kosmos Medical Group is a concierge primary care practice in Seattle's Madison Park neighborhood.

What membership includes

• Same-day or next-day appointments, with visits that run as long as needed
• 24/7 direct access to your physician by phone or text, not a triage line
• A comprehensive annual health assessment built around our eight focus areas
• Care for urgent concerns in the clinic, handled by physicians with emergency medicine experience
• Coordination of specialists, imaging, and hospital care, with your physician staying involved
• For Optimal Care members, advanced diagnostics including whole-body MRI, VO2 Max testing, and multi-cancer early detection

How the model actually works

Concierge medicine is often described in terms of amenities: the direct phone number, the shorter wait, the longer visit. Those are real, but they are downstream of one number.

A primary care physician in a conventional insurance-based practice typically carries a panel of somewhere between 1,900 and 2,500 patients nationally. That panel size is not a choice the physician makes. It is what insurance reimbursement requires: the practice has to run enough encounters per day for the arithmetic to work, which produces the 15-minute appointment, the three-week wait, and the triage line between you and your doctor.

Concierge practices replace some or all of that reimbursement with a membership fee, which lets the panel shrink. How far it shrinks is the whole story. A practice that halves its panel to 1,000 patients is a meaningfully better version of the same model. A practice that cuts it to a few hundred is running a different model.

Each Kosmos physician holds a panel of 100 families. Everything else on this page follows from that constraint. Same-day appointments are possible because the calendar has room. A physician can answer a message at 9pm because there are not 2,000 people who might send one. An annual visit can run two hours because it is not competing with 25 other slots that day.

When you evaluate any concierge practice, including this one, ask for the panel number before you ask about anything else.

Three physicians, one standard of care

Kosmos is not a solo practice. Our physicians are Dr. Chris Dodd, our founder, board-certified in internal medicine; Dr. James Bhaskar, a family medicine physician with more than three decades of clinical experience, including more than 18 years in emergency medicine; and Dr. Carolan Constantine, board-certified in internal and emergency medicine with a focus on women’s health. Each physician serves 100 families.

That structure solves a problem solo concierge practices cannot. When your physician is away, coverage is a colleague inside the same practice who can open your chart, not an answering service or an outside call group meeting you cold.

The emergency medicine depth matters in practice too. When something urgent happens, your first call is a physician who knows you and can handle most problems directly, which often means avoiding an urgent care visit or an emergency department wait entirely.

Built for prevention, not just access

Fast appointments are the baseline of concierge medicine, not the point of it. The Kosmos program is organized around eight focus areas, from metabolic health and cardiopulmonary fitness to genetics and advanced cancer screening, so that each year produces a clear picture of where your health is heading and a plan to act on it early. You can see the full program on our focus areas page.

What the annual assessment actually covers

The eight focus areas are not a menu of add-ons. They are the structure of the annual review, and each one exists because it changes decisions.

Kosmos Mindset. Sleep, stress, cognitive health, and the behavioral side of everything else. The most sophisticated testing in the world does not help a person who cannot sleep.

Metabolic Health. Insulin resistance shows up years before a diabetes diagnosis, and for much of that window its progression can be slowed or reversed. This is where continuous glucose monitoring and advanced lipid testing earn their place.

Cardiopulmonary Fitness. VO2 max is among the strongest available predictors of all-cause mortality, and unlike most predictors it is trainable.

Strength, Mobility, and Balance. What determines independence in the last decades of life, measured rather than assumed.

Women’s and Men’s Health. Hormonal health across midlife, handled inside the primary care relationship rather than referred elsewhere by default.

Advanced Cardiovascular Screening. Coronary CT angiography and plaque analysis can find disease that a standard risk calculator misses.

Genetics. Where inherited risk changes what we screen for and when we start.

Advanced Cancer Screening. Multi-cancer early detection testing and whole-body MRI, used with a clear-eyed view of what they can and cannot rule out.

For Premium Care members, the annual assessment is a thorough, unhurried review across these areas with standard testing. For Optimal Care members, the advanced diagnostics are included rather than referred out.

Women’s health at Kosmos

Women’s health is a core focus, led by Dr. Carolan Constantine. Members navigating midlife changes can read more about our menopause and perimenopause care, hormone replacement therapy, and what it means to have a female concierge doctor in Seattle.

What concierge medicine costs in Seattle

Seattle concierge memberships span a wide range, and the spread tracks panel size more than anything else. MD², which publishes its own guide to concierge pricing, divides the market into three bands, and they are a fair description of it.

Tier	Annual range, per MD²’s guide	What changes
Entry	$2,000 to $4,000	Shorter waits and a longer physical. The panel often stays in the hundreds. The practice usually still bills your insurance.
Mid-tier	$5,000 to $10,000	Panels shrink further. Advanced testing starts being included rather than referred out.
Ultra-personalized	$15,000 to $40,000	Panels of 50 families or fewer. Near-unlimited availability, priced accordingly.

Kosmos sits across the middle and the bottom edge of the top: Premium Care at $6,900 a year falls inside the mid-tier band, and Optimal Care at $15,000 sits at the bottom of the ultra-personalized band, though with a panel of 100 families rather than the 50 or fewer typical of that tier. Other guides draw the lines differently, and the bands matter less than what sits behind them.

Locally, published Seattle prices run from about $310 a month at MedNorthwest and $335 at Seattle Premier Health up to the Kosmos tiers, and several practices publish nothing at all. We keep a practice-by-practice comparison of Seattle concierge doctors with each practice’s published price and panel size, and a fuller breakdown of what concierge medicine costs in Seattle.

Clear pricing, no surprise billing

Membership is two plans: Premium Care at $575 per month, and Optimal Care, which adds the full advanced diagnostics program, at $1,250 per month. Children of members aged 15 to 29 can join for $200 per month each. There are no per-visit charges and no surprise bills. See membership and pricing for the full comparison.

Insurance, Medicare, and HSA questions

You keep your insurance. A membership is not insurance and does not replace it. Your plan continues to cover specialists, imaging, hospitalization, surgery, emergency care, and prescriptions. What changes is only the primary care relationship.

We do not bill insurance for primary care. Not billing is what makes the long visit possible, since insurance billing is what forces the short one. It also means the membership is not offset by reimbursement, which is a real cost and worth weighing.

We have opted out of Medicare. Medicare continues to cover your specialists, imaging, hospital care, and prescriptions exactly as before. It does not pay for primary care visits with us. Some concierge practices remain Medicare participating and bill it alongside their fee. Neither arrangement is wrong, and you should know which one you are signing.

HSA and FSA. Some costs may be eligible depending on your plan, and we are glad to walk through specifics. One caution: the rule that lets people pay membership fees from an HSA beginning in 2026 is written for direct primary care and caps the fee at $150 a month for one person and $300 for arrangements covering more than one. Concierge memberships at our price point do not qualify under it.

What concierge medicine does not do

A membership does not make you a different patient with a different body. It does not guarantee an outcome, and no amount of screening eliminates risk. Advanced testing produces findings that turn out to be nothing, and chasing them has its own costs in worry, radiation, and follow-up procedures. Part of what you are paying for is a physician with the time and judgment to tell you when not to chase something.

It also does not replace specialists or a hospital. What it does is put a physician who knows you in the middle of those decisions, rather than leaving you to coordinate them yourself.

For a healthy 35-year-old who sees a doctor twice a decade, the honest answer is often that this is not worth it yet. We will tell you that on the call.

What your first year looks like

1. A thirty-minute call with one of our physicians.
2. Enrollment and records transfer. We request your records for you, and you have your physician’s direct number the same day.
3. A first visit of ninety minutes or more. Most of it is conversation rather than examination, because the history is where the useful information is.
4. The annual assessment across the eight focus areas, with advanced diagnostics for Optimal Care members.
5. A written plan that says what we found, what it means, what we are doing about it, and what happens next year.
6. The rest of the year, which is the point: a physician who is reachable when you need one, and paying attention when you do not.

If you are moving from another practice, our post on switching to a concierge doctor walks through records, insurance, and timing.

Why 100 families, and not 50 or 400

The panel number is a design decision, and practices land in different places for defensible reasons.

At 400 or more, the economics work well for the practice and the experience is a faster version of conventional care. At 50 families, availability is close to unlimited, and the fee has to cover the physician’s entire practice out of very few members, which is why that tier starts around $15,000 a year and runs much higher.

We chose 100 families because it is the point where the things people actually want become structurally possible without pricing the practice out of reach for a working professional or a family. Same-day appointments, visits measured in hours, a physician who answers directly, and an annual program with real diagnostics behind it. Below that number the marginal gain is availability you are unlikely to use. Above it, the promises start depending on nobody needing much at once.

That is our judgment, not a law. What matters is that a practice can tell you its number and explain why.

When you need a specialist or a hospital

Most of what happens in a year happens inside the practice. The rest is coordination, and it is where a concierge relationship earns its keep in a city with several large health systems.

Your physician makes the referral personally, sends the relevant history rather than a fax cover sheet, and stays involved afterward. When you are admitted somewhere, you have a physician who knows your history and can talk to the team caring for you. When two specialists give you conflicting advice, you have someone whose job is to reconcile it.

Specialist care, imaging performed outside the practice, and hospitalization run through your own insurance as they always have. What changes is that you are not the one holding the whole picture together.

In Madison Park, serving greater Seattle

The clinic is at 3130 E Madison St Suite 204, in Seattle’s Madison Park neighborhood, a short drive from most of the city’s east side. Members come from across Seattle and the Eastside, including Capitol Hill, Montlake, Madrona, Leschi, Laurelhurst, Windermere, Broadmoor, Queen Anne, downtown Seattle, Mercer Island, and Bellevue.

Parking is straightforward and appointments start on time, which sounds like a small thing until you compare it with a hospital campus.

Who this is for

• People who want a doctor who knows them, with time to think about their health rather than react to it
• Families who value one practice caring for parents and adult children together
• Busy professionals who need same-day access and direct answers, not phone trees
• Anyone focused on longevity who wants advanced screening done systematically, year over year

How to compare us with other practices

We would rather you interview two or three practices than take our word for it.

Our comparison of Seattle concierge practices lays out the questions that separate them, and answers them for every practice that publishes enough to be answered. Our post on how MD², MDVIP, and Kosmos differ goes deeper on the models. And if you would rather just ask, schedule a call.