Your first visit is a comprehensive intake — not a rushed meet-and-greet. Plan for 60 to 90 minutes. Dr. Lopez will review your full medical history, current medications, past records, and family history. He will conduct a physical examination and discuss your health goals, concerns, and anything you have been meaning to ask a doctor but never had the time.
Before your visit, our team will request records from your previous providers and any recent lab work so that nothing is duplicated and nothing is missed. You will leave your first appointment with a clear picture of where your health stands, what needs attention, and a plan for getting there.
No. This is not health insurance and does not replace your insurance. Your membership covers your primary care — the relationship with your physician, office visits, direct access, care coordination, and everything listed in the Membership section. You should maintain your health insurance for hospitalization, emergency care, specialist visits, imaging, lab testing and prescription coverage.
Think of it this way: insurance covers catastrophic and specialty care. Your Sereno membership covers the physician who actually knows you and manages the rest.
Yes. If you are enrolled in Medicare Part B, your membership fee covers the concierge access services — same-day appointments, direct physician access, extended visit times, and all the enhanced access benefits of membership. Clinical services such as office visits, wellness exams, and chronic disease management are billed directly to Medicare. You remain responsible for any applicable Medicare deductibles, copayments, and coinsurance.
No portion of your membership fee is applied toward or credited against any Medicare-covered service. The two are kept completely separate.
Absolutely. When specialist care is needed, Dr. Lopez manages the referral, communicates with the specialist, transfers relevant records, and follows up to make sure nothing falls through the cracks. You are never left to navigate the system on your own.
Specialist visits are billed through your insurance — they are not included in your Sereno membership. But the coordination, advocacy, and follow-up are.
At Methodist Hospitals, Dr. Lopez serves as your attending physician — managing your care directly, coordinating with specialists, reviewing treatment decisions, and overseeing your discharge and transition home. He is personally available for hospitalized members at least 95% of the year. During planned absences, Complete Care Medical Associates — a trusted hospital-based physician group he works closely with — provides coverage with his direct involvement.
At non-Methodist facilities, Dr. Lopez has limited access to your hospital records and resources. He will communicate with the attending physicians to the extent possible, but cannot manage your care with the same level of involvement. For this reason, when hospitalization is anticipated and clinically appropriate, we coordinate admission at Methodist whenever possible.
Membership has a six-month initial term, then continues month-to-month. After the initial term, you may cancel at any time with written notice. Your membership remains active for 30 days after cancellation, so there is no gap in your care. During that time, we will provide referral letters to other providers and transfer your medical records promptly. Any prepaid fees are refunded on a prorated basis.
There are no cancellation penalties.
For true medical emergencies, call 911 or go to the nearest emergency room — always. Your membership does not cover emergency department services.
For urgent but non-emergency concerns after hours, Dr. Lopez is available 24/7 at least 95% of the year. During planned absences, a qualified, board-certified colleague will be available. You will always have someone to call.
No. Sereno Medicine is a private medical practice, not a 501(c)(3). Membership fees and contributions above the floor are not charitable donations and are not tax-deductible as such.
Concierge fees in San Antonio vary considerably across practices. Sereno Medicine membership starts at $125 per month, billed monthly, with a six-month initial term. There are no enrollment fees and no cancellation penalties after the initial term.
Members who choose to contribute above the $125 floor fund sponsored memberships for patients in financial hardship through the Sereno Sponsors Program. The full pricing structure is on our pricing page.
Concierge medicine and direct primary care are closely related but not identical. Both involve a monthly membership paid directly to the physician, and both reduce the patient panel so that the physician has the time required for unhurried care. The differences are largely operational: pure direct primary care practices typically do not bill insurance at all, while concierge practices generally continue to bill insurance for clinical services.
Sereno Medicine does not bill commercial insurance. For non-Medicare members, membership covers both concierge access and clinical care. For Medicare members, membership covers concierge access, and clinical visits are billed to Medicare.
As of January 1, 2026, federal law treats the fee for a qualifying direct primary care arrangement — one providing only primary care services for a fixed periodic fee — as an expense payable from an HSA, and such an arrangement no longer disqualifies you from contributing to an HSA if the fee is no more than $150 per month for an individual or $300 for more than one person. For non-Medicare members, the $125 membership fee is within that limit and is the sole fee for your primary care. For Medicare members, clinical services are billed to Medicare rather than covered by the fee, so the membership likely does not qualify.
FSA rules are separate and not yet settled. Whether your membership qualifies depends on your plan and circumstances — consult your tax advisor or HSA administrator, and we will provide any documentation you need.
Time. The average primary care physician in the United States manages a panel of more than 2,000 patients and spends about 15 minutes per visit. That math does not allow for careful diagnosis, thoughtful preventive planning, or unhurried conversation.
By limiting the practice to a deliberately small panel, Dr. Lopez protects the time required to practice medicine the way it should be practiced. Quality of attention is structurally guaranteed, not earnestly hoped for.
Same-day or next-day for established members in nearly all cases. Visits last as long as the conversation requires, not a fixed slot length.
Direct physician access by phone, secure message, and email means many concerns are resolved without needing an in-person visit at all.
No. Sereno Medicine is an internal medicine practice; we care for patients 17 and older. Our family add-on covers children of a full-rate member, ages 17 through 25 — typically young adults transitioning out of pediatric care.
For pediatric care, we are happy to recommend trusted pediatricians in San Antonio.
Sereno Medicine is located at 8122 Datapoint Drive, Suite 1110, in the South Texas Medical Center area of San Antonio.
Members come from across San Antonio and the surrounding area, including Stone Oak, Alamo Heights, Olmos Park, Terrell Hills, The Dominion, Shavano Park, Hill Country Village, Boerne, Fair Oaks Ranch, and Helotes. Home visits are included when clinically appropriate.