Medicine Built Around You.
Not Your Insurance Plan.
Concierge Internal Medicine in Folsom & El Dorado Hills — Direct Primary Care for adults under 55, Longevity Internal Medicine for adults 55+ or as an add-on at any age.
Your doctor manages 2,500 patients. Ours manages 300. That's the whole difference — and every other thing on this page follows from it.
Direct Primary Care from $149/mo · Concierge Longevity Program from $299/mo · HSA-eligible (DPC)
Why This Practice Exists
“I spent two decades in academic and hospital medicine — teaching residents, managing critically ill patients, running research programs. But the system that trained me was also the system that gave me 15 minutes per patient and 2,000 names on a panel. I started this practice to do what I was trained to do: know my patients, think carefully, and be there when it matters.”
— Nishant Sahni, MD
Your Physicians
Nishant Sahni, MD, MS
Founder & Physician · Internal Medicine · Clinical Informatics
Focused on integrating longevity science into primary care. Speaks English, Hindi, Urdu, and Punjabi.
The Concierge Medicine Experience — What This Looks Like in Practice
Concierge primary care, longevity medicine, and direct primary care all come from the same idea: a small patient panel changes how the practice operates. Because the panel is small, the way you experience care is different from a typical primary-care office.
- Direct physician access. Reach your physician directly by phone, text, or secure messaging — no phone tree, no portal callback queue, no front-desk gatekeeping for clinical questions.
- Same-day and next-day appointments. Typically same or next day — not the 2–6 week wait common in traditional primary care.
- Same- or next-day response for clinical questions during business hours. Most days the response is within a few hours.
- Unhurried visits. Appointments last as long as needed. Visits end when the conversation does, not when the schedule clock runs out.
- Specialist coordination. Curated specialist referrals and coordination with your full care team.
- Continuity of care. You see the same physician every time. Your story doesn’t restart at every visit.
- Comprehensive annual physical. Executive-style physical with full cardiometabolic workup, longevity-relevant biomarkers, and physician-interpreted results.
- Thoughtful clinical reasoning. Diagnostic and treatment decisions made with time to think — not 12 minutes between charting tasks.
Why Patients Choose Concierge Primary Care
Patient panel cap — a fraction of the 2,000–3,000 typical primary care panel.
Fewer ER and urgent-care visits reported in concierge primary care vs traditional models (industry data).
Combined former Mayo Clinic and University of Minnesota faculty experience.
English, Hindi, Urdu, Punjabi — multilingual concierge medicine in Folsom & El Dorado Hills.
How It Works
Join
Pay $299 to get started — includes your 60-minute initial evaluation with baseline labs and first two months of membership.
Establish Care
Your physician reviews your history, runs baseline labs, and sets the year's plan with you.
Stay With Us
Ongoing internal medicine care, wholesale labs, and (for 65+ or as an add-on) Concierge Longevity Program.
A typical primary care physician manages 2,000–3,000 patients. Our panel is capped at 300.
Our Programs
Two programs, one small-panel practice.
Direct Primary Care ($149/mo) includes:
- Full-scope internal medicine — chronic, preventive, acute, diagnostic
- Visits — up to 30 per year; additional visits $25 each
- Annual cardiometabolic labs — ApoB, Lp(a), fasting insulin, hs-CRP, and more
- Wholesale pricing — labs (Quest/LabCorp) and medications (Cost Plus Drugs, Amazon Pharmacy)
- HSA-eligible — pay with pre-tax dollars
Concierge Longevity Program ($299/mo · couples discount available) includes:
- Comprehensive primary care — small-panel internist
- Weight management — GLP-1 medical management when appropriate
- Hormone management — HRT and TRT when clinically indicated
- Sarcopenia monitoring — functional fitness assessment (grip strength, gait speed, sit-to-stand)
- Lifestyle advisory — nutrition, exercise, and sleep, integrated into your plan
- Comprehensive longevity panel — ~100 biomarkers annually via wholesale Quest, near-cost
- Advanced screening interpretation — Galleri, Prenuvo, Cleerly, epigenetic clocks, polygenic risk, wearable + CGM data
- Annual 90-minute Longevity Assessment + Personalized Longevity Blueprint
The way we work: Most longevity testing leaves you with a hundred numbers and no guidance. We run the panels, integrate them with your full picture, and tell you which findings actually matter for your year ahead. The fee buys judgment, not data.
How testing is priced: the comprehensive biomarker panel runs through our wholesale Quest account at near-cost (typically $50–150 vs $499/yr for retail panels like Function Health — same lab, same draw). Vendor-purchased tests (Galleri, Prenuvo, Cleerly, etc.) are bought directly from the vendor at standard retail. The Practice does not mark up any test.
What the fee covers: physician time interpreting and integrating longevity testing into your plan. What it doesn't: clinical visits (billed to Medicare or insurance as usual) and the tests themselves.
DPC: $299 to start — 60-min initial evaluation + first two months. Longevity: $299 first month — initial evaluation included. Cancel anytime with 30 days' notice, no contracts.
Looking specifically for medical weight loss? See our GLP-1 program.
Is This Right for You?
Likely a good fit if you:
- Want a small-panel practice with unhurried visits
- Have chronic conditions that benefit from attentive management
- Are 65+ and interested in longevity-focused internal medicine
Probably not a fit if you:
- Need pediatric care (we serve adults 18+)
- Prefer a large insurance-based health system
- Want traditional high-volume primary care
Questions We Often Hear
Is this concierge medicine?
Not in the traditional sense. Many concierge practices charge Medicare-enrolled patients access fees that overlap with services Medicare should cover — a regulatory gray area we deliberately avoid. We are a Direct Primary Care practice for adults under 65 (membership covers your primary care directly, no insurance involved), and a Concierge Longevity Program for adults 65+ in which Medicare is billed normally for all covered clinical services and the membership fee is allocated exclusively to non-covered longevity services. Same small-panel feel, cleaner structure.
Do you accept insurance?
DPC ($149/mo): membership model, not insurance-based. Longevity ($299/mo, 65+): Medicare is billed normally for covered services. The membership fee covers only non-covered longevity services and does not modify any Medicare benefit.
I'm 65 or older and on Medicare — how does this work?
You enroll in Concierge Longevity Program. For members on Medicare, Medicare is billed normally for all covered clinical services — visits, preventive care, chronic disease management, Medicare-covered labs. The $299/mo membership fee is allocated exclusively to non-covered longevity services — the 90-minute Longevity Assessment, advanced testing interpretation, Longevity Blueprint, and the other services in the program. No portion of the fee covers any Medicare-reimbursable service, and the membership fee does not modify, reduce, or waive any Medicare benefit or cost-sharing obligation. This is structured to comply with Medicare assignment rules and Office of Inspector General guidance.
Can I use my HSA or FSA?
Yes. As of 2026, DPC memberships up to $150/month are fully HSA-eligible. Our membership ($149/mo) qualifies in full. The $299 enrollment (initial evaluation + first two months) is also HSA/FSA eligible.
Do I still need health insurance?
Yes. Maintain a health plan for hospital stays, emergencies, specialists, and prescriptions. Many members pair this membership with a high-deductible or catastrophic plan.
Can I cancel my membership?
Yes. There is no long-term contract. You may cancel at any time with 30 days' written notice. There are no cancellation fees.
Reserve Your Spot
Founding memberships are limited. We'll reach out to schedule your evaluation.