Concierge doctor

In order for the fee of a so-called concierge doc to be deductible as a medical expense, it has to be paid and medical services have to be provided. (It's not medical insurance). But when must the payment be made? Examples:

Pay in January year 1, services rendered after that date and in year 1.
Pay in February year 1, services rendered before that date and in year 1.
Pay in December year 1, services rendered after that date and in year 2.
Pay in January year 2, services rendered before that date and in year 1.
In each example, assume the concierge contract is effective before both payment date and services-rendered date.

Here's some stuff to muddy the waters.
http://www.taxalmanac.org/index.php/Dis ... IP_MD.html
viewtopic.php?f=8&t=10439&p=95930&hilit=concierge#p95930
viewtopic.php?f=8&t=2179&p=25324&hilit=concierge#p25324

Is the upfront fee more of a non-refundable fee merely to have access to the doctor, be a patient of the practice, etc, and the patient must pay separately for any services rendered?

Or is the upfront fee earned by the doctor over time and the patient gets invoices showing the amount of upfront fee applied to the current balance?

Neither one. A flat annual amount paid upfront for 24/7/365 access, not refundable based on not needing the doc. No separate fees. If patient cancels or dies, pro rata refund is made.

Interesting comment by one person "...I don't see this lasting." The date of the TA discussion noted by Len is 2010. I have a client who was doing this when he first came to my office in about 2007 or so, sold his practice in about 2013, and has now started a smaller practice. In all three instances he has used the concierge model. Most of those signing up for it, according to the client, are people who are snowbirds. For them, it's just easier to fly into town knowing that if anything happens to them, they have a medical connection and they don't need to worry about their insurance being accepted or not. BTW, it costs WAY more than $1500 and alwyas has.