You have had type 2 diabetes for more than a decade. You pay around $600 a month for insurance and keep the appointments it allows. The diabetes is still not well managed. In all those years, no clinician has sat down with you and explained the whole metabolic picture.
The fix that comes to mind is a private doctor with time and a phone number that answers, at a practice that charges $20,000 a year. This piece weighs concierge medicine for type 2 diabetes against a $299-a-month membership. It gives both sides' year-one totals with the date on every price. It also says plainly where the concierge practice is the better purchase.
GoodLife Health manages type 2 diabetes online, with A1C drawn every quarter and branded medication, including Mounjaro, where a clinician finds it indicated. It sits between the $20,000 concierge practice and the $99 app, with quarterly labs and a clinician who stays. The fee is $299 a month in all fifty states.
- Concierge medicine sells a physician's time. Every tier in our September 2026 pricing guide still sits on top of your insurance.
- Ultra-premium concierge retainers ran from $4,000 to more than $25,000 a year as of September 2026, before insurance.
- The GoodLife Health membership is $3,588 a year, plus medication at your own pharmacy's price, with your insurance kept in place.
- Nine biomarkers are drawn four times a year, with A1C and fasting insulin among them. Every result is yours.
- Medication goes to the pharmacy you choose at its price. GoodLife Health takes nothing on it.
- If you want house calls or private urgent care, the concierge practice is the better buy.
What a decade of diabetes care has looked like
Most long diagnoses settle into the same rhythm. Blood is drawn and the A1C is read back in a short visit. A dose is adjusted or a medication is added. The next appointment is months away. Then the cycle repeats.
You have probably done what was asked of you. You took the medication, changed what you ate and came back when you were told to. A decade of that produces a long record and very little understanding.
The results sit in a portal with flags beside some of them. Nobody has told you how the A1C relates to the cholesterol, whether fasting insulin was ever drawn or what the thyroid result means for the rest. You may never have seen an ApoB or an Lp(a) result at all. When you asked why the number would not move, the answer was probably another adjustment.
The whole metabolic picture is a phrase worth defining, because nobody has defined it for you. It means A1C and fasting insulin read beside ApoB, Lp(a), hs-CRP, the lipid panel and the thyroid. It means one person who knows your history reading them as one system.
None of this is a failure on your part. The standard visit is built for a short look at one number. A long diagnosis needs someone to read many numbers together and to keep reading them over years. Those are different jobs. The eight-minute visit has room for the first one only.
Insurance at around $600 a month has bought you access to that visit and protection if something serious happens. It has not bought you an explanation. Nor has it bought continuity. You may have seen several clinicians over the years, each reading the latest result without the history behind it.
So the concierge practice starts to look sensible. A physician with fewer patients would have time. A physician with time would explain. The instinct behind the search is sound, because what you want is reasonable. You want one person to own the whole picture, follow it closely and answer when you have a question.
The question is whether $20,000 a year is the only way to get that. A second question is whether the retainer buys it at all.
What a concierge fee buys and what it leaves out
Concierge medicine sells a physician's time. The practice keeps its panel small and charges a retainer for the difference. That model is honest about what it sells. It helps to be equally clear about what it does not include.
Our pricing guide compiled public pricing pages in September 2026. It found mid-tier concierge retainers from $1,500 to $5,000 a year, in a category that includes MDVIP, SignatureMD and PartnerMD. The fee bought a smaller panel, longer visits, direct phone access and an annual wellness exam. The visits themselves were still billed to insurance. Ongoing labs, hormone care and GLP-1 protocols varied by physician.
The ultra-premium tier is where the $20,000 in your question belongs. The same guide recorded retainers there from $4,000 to more than $25,000 a year as of September 2026. That money bought private urgent care, house calls and a physician who takes on around 50 families. Separate insurance was still required. Specialty care was billed on top.
So the year-one total for concierge care is the retainer plus your full insurance cost. In your case, that is $20,000 plus the roughly $600 a month you already pay, before any medication.
Some concierge physicians use that time very well. They order a broad panel, repeat it on a schedule and walk you through every result. If you find one who does, you have found something real. The price may be worth it to you.
The difficulty is that the retainer does not guarantee any of it. A retainer buys availability. A decade of diabetes calls for a workup at the start. After that, it calls for the same markers followed on a fixed cadence and read by the same clinician. Whether a concierge practice delivers that depends on the physician you happen to choose.
Before you sign with any practice, ask which markers are drawn and how often they are repeated. Ask who reads them and what is billed on top of the retainer. Those four answers tell you more about the care than the size of the fee does.
Nobody has read a decade of your results back to you as one picture.
Cardiometabolic medicine is moving toward testing before treating. ApoB and fasting insulin are read where LDL and glucose once stood alone. Membership care is replacing the eight-minute visit for people who can step outside it.
One more question applies to any care model, concierge or online. Who earns money when your medication changes? Our white paper on how GLP-1 telehealth companies make money sets out the three ways a telehealth company gets paid. Its central finding is that the way a company gets paid is the pressure its clinicians work under.
What the membership does for a long diagnosis
The membership starts with the labs. Before anything is prescribed, a clinician licensed in your state orders a panel of nine cardiometabolic biomarkers. The same panel is drawn every 90 days after that, four times a year. A1C, fasting insulin, ApoB, Lp(a), hs-CRP, the lipid panel and TSH With Reflex To Free T4 are among them. Every result goes into your hands.
Then one clinician reads them with you and keeps reading them, quarter after quarter. For someone with a decade of diabetes, that changes the conversation. The A1C is read together with fasting insulin. ApoB, Lp(a) and hs-CRP are in every panel, so the risk to your heart is measured each quarter. The thyroid result is there every quarter as well. Over a year, you have four sets of the same markers, which is how a trend becomes visible.
In practice, the first quarter runs in a set order. You complete the eligibility check and the intake. A clinician reviews them. If you are accepted, the first panel is drawn and the clinician reads it with you. The aim of that first reading is that you understand each number and the plan for the next 90 days. You can message the care team between visits. Video visits are part of the fee.
When a medication is indicated, the clinician prescribes it to the pharmacy you choose. That pharmacy bills you at its own price. GoodLife Health sets nothing, sees nothing and takes nothing on medication. Prescribing is limited to branded, FDA-approved medication. For diabetes, that can include Mounjaro or Ozempic. Any other FDA-approved medication the clinician judges indicated can also be sent to your pharmacy.
Your insurance may cover a medication. Whether it does is between you, your plan and the pharmacy. GoodLife Health never promises coverage. Prior authorization is the pharmacy's process.
The fee does not move with the answer. It is the same whatever medication is indicated and whatever the dose. There is no molecule upcharge and no dose upcharge. That is the difference from the $99 app at the other end of the market. A company that earns on medication is paid when medication is sold. GoodLife Health is paid the same fee whether a clinician starts a new prescription or decides you need none.
You should also know what the membership does not do before you compare. Continuous glucose monitors are not part of the model. The model is built on quarterly blood work read by a clinician. The membership does not replace your insurance. It pairs with insurance for catastrophic cover and replaces the primary-care relationship for your cardiometabolic health. Specialists, imaging and hospital care stay with your plan. It does not promise remission, a cure or any particular result. It is also not a house-call service, because the care happens by message and video.
Year one, side by side
Retainers as published in September 2026, with your insurance continuing under every option
| Option | Annual fee | What the fee buys | Billed on top | Year one |
|---|---|---|---|---|
| GoodLife Health membership | $3,588 | One clinician, nine biomarkers four times a year, messaging and video visits | Medication at your pharmacy's price | $3,588 plus medication and your insurance |
| Ultra-premium concierge | $4,000–$25,000+ | Private urgent care, house calls, a physician capped at around 50 families | Separate insurance, plus specialty care | Retainer plus your full insurance cost |
| Mid-tier concierge | $1,500–$5,000 | Smaller panel, longer visits, direct phone access, an annual wellness exam | Visits billed to insurance, with labs varying by physician | Retainer plus your full insurance cost |
| Insurance-based primary care only | $0 | Whatever your plan covers, at 8–18 minutes a visit | Premium, deductible and copays | Your full insurance cost |
Insurance-based care was never free, even before a retainer enters the picture. The KFF 2025 Employer Health Benefits Survey put the average employee's premium contribution at $1,440 a year and the average deductible at $1,886. Keep your plan under either choice. It is what protects you in a hospital.
The price works like this. The membership is $299 a month. At sign-up, $598 is held on your card to cover the first two months. It is charged only once the clinician accepts you into care. If the clinician cannot accept you, the hold is released and you are never charged. Once you are accepted, the first two months are charged and are non-refundable. From month three, the membership is month to month. Medication billed by a pharmacy follows that pharmacy's own return and refund policy. Not everyone is accepted. The path runs from the eligibility check to the intake, then the checkout, then a clinician's review.
The membership draws A1C every quarter beside fasting insulin, ApoB, Lp(a), hs-CRP and the lipid panel. One clinician reads them together, which a single A1C at a short visit cannot offer.
The honest answer to the $20,000 question
If you want a physician at your door, private urgent care and direct phone access, the top concierge tier sells exactly that. Pay for it if those things matter to you and the cost does not trouble you.
If what has been missing for a decade is the workup, the membership is built around it. That means the markers drawn on a schedule, read together and explained by one clinician who stays.
Under either choice, keep your insurance. The membership's year one is $3,588 plus medication at your pharmacy's price. The concierge practice in your question is $20,000, also before medication. Both sit on top of the roughly $600 a month you already pay.
We do not know your numbers yet. We will not guess at them here. Nobody should promise you a result before reading them.
Whatever you decide, do one thing this week. Gather every lab result you can find from the past few years into one place, with each medication and dose beside it. Then ask the clinician you see next which of these have ever been drawn: fasting insulin, ApoB, Lp(a) and hs-CRP. Ask for copies of any that were. If none were, you have learned something useful about the care you have been getting. Bring that list to any practice you interview.
Who this is not for
This is not for someone whose diabetes is well managed by a clinician who already reads the whole picture with them. Stay with that clinician.
It is not for anyone who wants house calls or private urgent care. The concierge practice is the right purchase there.
It is not for someone who wants a glucose-monitor program, compounded medication or the cheapest possible prescription. GoodLife Health prescribes branded, FDA-approved medication only. The $99 app is built for a different purchase.
It is not a replacement for insurance. Anyone hoping to drop coverage should keep looking.
It is not for anyone who wants a guarantee. No honest clinician can promise how a decade of diabetes will respond.
It is available only to people living in the United States. Not everyone who applies is accepted.
If you are the person this was written for, here is the offer plainly. GoodLife Health is $299 a month. At sign-up, $598 is held for the first two months and charged only once a clinician accepts you. If you are not accepted, the hold is released and you are never charged. Once you are accepted, those two months are non-refundable. After them, the membership is month to month. It buys a quarterly panel, a clinician who stays and medication prescribed to your pharmacy at that pharmacy's price, with nothing taken on it. It returns what a decade of visits never produced: an explanation of your diabetes and the markers around it, followed every quarter. It is different because it tests first, treats second and sells neither the drug nor the dose. You have waited more than a decade for this conversation. The next A1C will be drawn either way. It can be read alone again or read with the full panel by someone who will still be there for the one after.
Related Reading
- The Real ROI of a $299/Month Health Membership: Every Alternative, Priced Honestly
- How GLP-1 Telehealth Companies Make Money: A Plain-Language Whitepaper
References
- MDVIP — membership overview and fees. 2026. www.mdvip.com/
- 2025 Employer Health Benefits Survey — Kaiser Family Foundation. 2025. www.kff.org/health-costs/2025-employer-health-benefits-survey/