The additional value is the primary-care relationship itself: time with a physician who knows you, covered visits, communication, and coordination defined by the membership.
Medicare remains relevant for eligible care provided outside that relationship. The two payments have separate roles rather than buying the same service twice.
Medicare does not pay the membership fee
Medicare.gov explains that Medicare does not cover membership fees for concierge or direct care. The patient pays that fee for the services or access described in the agreement. Paying for membership does not replace Medicare, and having Medicare does not turn the membership fee into a covered Medicare claim.
What someone may value in addition to Medicare
The reason to consider DPC is the primary-care relationship itself: knowing which physician follows your care, having more time to discuss concerns, and having a clearer way to reconnect between visits. Medicare and other coverage still address eligible services delivered elsewhere.
How Magnus currently works with adults 65 and older
Magnus offers membership for adults 65 and older at $125 per month. Members can continue using Medicare for eligible outside services such as specialists, laboratory work, diagnostic testing, and Part D medications. Magnus does not bill Medicare for primary-care services covered by its membership agreement.
The Magnus agreement defines the membership services. Medicare or another payer determines whether an outside service is covered and what the patient owes.
What happens when care moves outside Magnus
- A Magnus visit covered by membership is handled through the membership.
- An outside specialist bills under that specialist’s Medicare arrangement and the patient’s coverage.
- Outside laboratories, imaging centers, pharmacies, hospitals, and equipment suppliers apply their own Medicare and billing rules.
A referral or order does not by itself guarantee Medicare coverage. Medical necessity, benefit rules, provider participation, frequency limits, and the patient’s plan can all affect payment.
Why the physician’s Medicare status matters
Medicare rules differ depending on whether a physician participates, does not accept assignment, or has formally opted out and uses private contracts with Medicare beneficiaries. The practice agreement must reflect its actual Medicare status.
Before joining, make sure you understand what Magnus membership covers, which outside services continue through Medicare, and which costs remain yours. Review Magnus membership information and contact the practice with questions about its current arrangement. Questions about your individual Medicare benefits should go directly to Medicare or your plan.