Since not every medical situation can be taken care of remotely, Guardian does have services that support on-site response to immediate emergencies. The firm, for example, can outfit a vehicle at the client's home that can be used to transport clients to medical facilities.

"You have no wait time for the ambulance to arrive," O'Mara says. The firm also has relationships with local contractors who can drive and staff the vehicle, and are given detailed instructions on how to get to the client's home, to avoid delays, he says. The firm also has relationships that provide medical airlifting services in extreme emergencies.

The firm also provides a service that essentially installs a medical ready room on a client's private jet plane or yacht.
"We provide medical solutions that range from $50,000 in medical equipment up to about $300,000," Darling says.

"Basically we provide the same best-of- breed emergency medical solutions that we offer in a client's home, but in this case designed for the limited space of a jet."

Guardian 24/7's baseline service offering costs $25,000 annually for a single person or $50,000 for a family of four. This gives clients immediate access to the firm's physicians 24 hours a day, seven days a week, via telephone. It also allows for a comprehensive offering of consultation services, including planning for medical needs during overseas trips, a database of top specialists and customized personal medical kits.

The ready room is an added service. It can cost up to $1 million to equip the ready room, according to Guardian. The clients own the equipment, which is maintained by Guardian.

Despite a sagging economy, many ultra-high-net-worth families are kicking the tires and considering this type of coverage. "I would say interest has spiked a bit in response to the idea of major government intervention into health care," Frye explains.
With little advertising, Guardian 24/7 relies on word-of-mouth referrals to grow its business. "There are a number of different sources connecting us with clients. We have White House staffers suggesting us, since they are obviously aware of the level of service required to work in such an environment," Frye says. "But we are most often contacted by single and multifamily offices where advisors to ultra-high-net-worth families find us in their research process. We also have many concierge doctors refer clients to us."

All of Guardian's doctors are currently former White House physicians, but as the firm grows, it is prepared for the day when it will utilize doctors who have not served presidents. "Yes, there exists a finite number of doctors with this type of experience," Frye says. "But when we get to that bridge, our new staff will be vetted and will be required to practice at the same level of excellence."

Guardian's current clientele cuts across a number of demographics, according to Frye. Clients include those nearing retirement age, people between 55 and 60 who want to improve their level of medical care as they age, he says. The majority of clients, however, start their relationships with Guardian while healthy, he says.

The firm, Frye notes, is not designed to provide the full scope of care required by those with serious chronic illnesses.