Marcelino D. Albuerne, MD in Baltimore: Internal Medicine with a Direct-Pay Model

Marcelino D. Albuerne, MD operates an internal medicine practice in Baltimore that uses a direct-pay (concierge) model, meaning patients pay an annual or monthly fee for access rather than billing insurance for office visits. This structure alters the typical primary care experience in significant ways, both for the patient schedule and the out-of-pocket financial picture compared to traditional insurance-based practices.

What this practice actually is

Albuerne's practice is structured around a membership model that emphasizes continuity of care and same-day or next-day appointment availability. Internal medicine in a direct-pay setting usually means fewer patients on the roster, longer visit times, and a shift in cost: rather than copays and deductibles tied to insurance, patients pay a flat annual or monthly membership fee that covers office visits, preventive care, and basic care coordination. Catastrophic care, lab work, and specialist referrals are typically billed separately or through insurance for those who maintain coverage.

This model is uncommon in Baltimore's primary care landscape, where most internists operate through traditional insurance networks at Johns Hopkins Health System, University of Maryland Medical Center, and independent practices that bill through plans. For patients seeking direct-pay internal medicine without the high-volume, appointment-in-three-weeks structure, this represents an outlier option.

Membership fee and what it includes

Direct-pay practices typically charge between $1,500 and $3,500 per year for membership, though specific pricing for Albuerne's practice should be confirmed directly by contacting the office. The membership generally covers unlimited office visits, preventive health assessments, and the ability to reach the physician by phone or secure messaging outside of appointments. Laboratory work, imaging, specialist referrals, and procedures are usually paid separately at market rates or through insurance if the patient maintains a policy.

The financial math differs sharply from insurance-based care. A patient with a $40 copay and a $2,000 deductible who visits an internist four times per year under insurance pays $160 in copays plus, if they meet the deductible, thousands more out-of-pocket before insurance contribution kicks in. A direct-pay patient paying $1,800 per year with no separate visit charges avoids the copay treadmill but must plan for bundled annual spending and may carry a separate catastrophic or accident policy.

How this compares to Baltimore's internal medicine landscape

Most Baltimore internists practice within hospital systems or independent groups that bill insurance. Johns Hopkins primary care clinics and University of Maryland Medical Center offer network-based internal medicine with copays and insurance coordination as the default. Wait times for new appointments at these systems typically run four to twelve weeks; established patients can sometimes schedule within two to three weeks.

Private practices unaffiliated with hospital systems, such as practices in Canton, Federal Hill, and Fells Point, follow insurance billing but may offer shorter wait times (one to two weeks) because they serve smaller patient rosters. Urgent care centers like Urgent Care Plus and Medrite handle acute complaints on a walk-in basis and cost less per visit ($150 to $250 without insurance) but do not provide continuity of care or management of chronic disease.

Albuerne's direct-pay model removes the insurance coordination step entirely, which speeds access but requires the patient to pay upfront and understand that catastrophic coverage remains their responsibility. This suits someone who values time with their physician and predictable annual costs over the insurance deductible-and-copay trade-off, but it does not suit uninsured patients looking for low-cost primary care or those relying on Medicaid or Medicare.

Who this practice suits and who it does not

This model works well for employed adults with stable incomes, self-employed professionals, or patients over 65 with Medicare supplemental coverage who want to minimize appointment delays and administrative friction. It also suits people managing multiple chronic conditions (diabetes, hypertension, heart disease) who benefit from frequent touchpoints without scheduling obstacles.

It is a poor fit for uninsured patients (the annual fee is a barrier), those on Medicaid or Medicare alone, patients with very low visit frequency, or anyone who prefers to avoid annual commitments. It does not suit patients who rely on insurance to cap their out-of-pocket exposure because catastrophic expenses fall outside the membership.

What the first visit involves

A new-patient visit with a direct-pay internist typically includes a detailed history, physical examination, review of prior medical records, and a baseline assessment of medications and chronic conditions. Because the appointment is not time-limited by insurance scheduling rules, these visits often run 45 minutes to over an hour. The patient should bring insurance cards (if applicable for specialist referrals), a list of current medications, and records from any recent hospitalizations or specialist care.

Before the first visit, the practice will explain the membership fee structure, what is covered under membership, and what triggers separate billing. Some practices require payment of the membership fee before or at the first appointment.

Hours, parking, and logistics

Because Albuerne's office address and current hours require direct verification, contact the practice by phone or website to confirm location, parking availability, and whether same-day appointments are available as advertised. Direct-pay practices often have flexible scheduling, including early morning, evening, and same-day slots, but hours vary by individual practice.

Baltimore internists who operate under traditional insurance (Johns Hopkins, University of Maryland, independent practices) publish standard hours on their websites and accept walk-in patients far less often than direct-pay practices. Parking in the practice location matters: offices in commercial buildings downtown or near hospitals often charge for parking or require validation.

Why Albuerne's practice matters in Baltimore's primary care market

A direct-pay internal medicine option adds choice to a primary care market dominated by large hospital systems and insurance-dependent scheduling. For patients willing to trade insurance coordination for access and continuity, this practice represents an alternative that exists but is not widely advertised. Baltimore's primary care shortage and appointment delays at major health systems have driven interest in concierge models among a subset of patients; Albuerne's practice is one of few Baltimore internists who operate this way.