It's getting a bit easier to find someone with a stethoscope to show up in your living room. But it may cost you a lot more than a $20 co-pay.

Until recently, house calls were somewhat akin to the corner soda fountain and the $1 bleacher seat -- a relic of simpler times before insurance companies, store-bought ice cream and million-dollar outfielders ruined everything.

Now, the in-home (or in-office or hotel-room) consultation is making a comeback. It's great news for those who don't mind paying to avoid the drive to the doctor when they have the spins or can't unchain themselves from their cube at work when a sinus infection strikes.

People who are old and sick, or very wealthy, have the best access to roving medical practitioners. In the late 1990s, Medicare increased reimbursement rates for house calls for certain patients. As a result, more doctors started making them.

One company, Care Level Management LLC, now sends staff physicians into the homes of chronically ill older people in several states. Search for other doctors offering such services at aahcp.org.

The wealthy have access to house calls thanks to the rise of "concierge" medicine practices. Doctors there often don't accept insurance and may charge four-figure annual fees. For that price, however, they will often come to your bedside. See simpd.org for more information and a list of doctors.

The house-call comeback, however, isn't limited to these two categories of customers. Microsoft, for instance, just started a pilot program that hooks Seattle-area employees up with come-to-you care.

The rest of us might begin with a search for specialized local services like New York's Sick Day Medical House Calls. Concierge services that come with high-end Visas and MasterCards or American Express's Global Assist Hotline can help.

Hotel concierges are good resources too -- even if you aren't staying in the hotel. Call anyway, and cough and sneeze for mercy. (Then send them a tip if they hook you up.)

Once you find someone to see you, you may have to pay in full at the time of service. The total cost could range from around $100 up to $500 or more.

If you have health insurance, reimbursement rates run the gamut. HMO plans or other plans that require you to see your primary-care physician first may not repay you.

Allowed to see doctors outside of your insurer's normal network without permission? You might get anywhere from 30 percent to 100 percent of the funds back. You may also be able to bring down the costs by using your health-care flexible-spending account (many employers offer these vehicles, which are funded pretax from your paycheck).

If you have regular doctors and you aren't traveling, it would be ideal if they would just come to you. Turns out they just might be willing. It helps if you live or work close to where they live or work and your schedule is flexible.

In the 2005 practice profile survey of the American Academy of Family Physicians, 19 percent of active members said they do one or more house calls in an average week.

So how come they don't advertise this fact to more of their patients? If word got out, perhaps nobody would want to wait around in their offices anymore.