Searched forum, unsuccessful, how to find doctors who take Medicare

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Jackson12
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Searched forum, unsuccessful, how to find doctors who take Medicare

Post by Jackson12 » Sun Mar 05, 2017 6:57 pm

According to the article linked below , published in 2015, it was not considered hard to find doctors who took Medicare patients. http://www.pbs.org/newshour/making-sens ... care-plan/

In our area of the country, just 2 years later, that info does not seem to be true. We live in a mid- sized Midwestern city which has many doctors and hospitals.

Our family doctor -who would have kept us on as Medicare patients- just retired. We are making appointments with possible new physicians and not having much luck in finding any that take Meducare patients,

Amy tips or suggestions? Is there already a relevant thread here? I couldn't find it.

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cheese_breath
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by cheese_breath » Sun Mar 05, 2017 7:00 pm

Have you checked the Medicare website?
https://www.medicare.gov/physiciancompare/
The surest way to know the future is when it becomes the past.

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celia
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by celia » Sun Mar 05, 2017 7:24 pm

Whenever you make an appointment with a new doctor, be sure to ask them if the doctor is contracted with Medicare, in case the Medicare site is not up-to-date. Sometimes the medical group, rather than the doctor name, will be listed instead.

Note that everyone "takes" Medicare payment. (I will "take" it and I don't even work in the medical field! :happy ) In fact, everyone will likely "take" payment from anyone and apply it to your account--from your insurance, a relative, a neighbor, your dog,... What you want to know, instead, is if the doctor or medical group agreed to the price that Medicare says the service should be paid at.

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dm200
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by dm200 » Sun Mar 05, 2017 7:30 pm

I have read, and have been told by many friends and acquaintences that in this area (Washington DC) it can be difficult to find Primary care Physicians who will take new patients on Medicare - although specialists, perhaps, may not be so difficult.

My wife and I chose a Kaiser Medicare plan - so we were not affected.

Most commonly, in this area, Physicians will accept existing patients who go on Medicare.

One friend of ours had a Primary Care physician for many years (individual practice), but was somewhat "stranded" when the Physician retired.

She finally (after a long search) found an acceptable Physician who would accept her. She told me that, based on being stranded, she now only would want a Physician in a group so that, most likely, if one of the group left or retired, other Physicians in the group would continue to accept her Medicare.

Depending on your area of the country, your individual situations, and plans available (or not), I suggest checking out Medicare Advantage plans. In this area, there are several excellent plans and they advertise heavily. There are multiple advantages and disadvantages of MA plans.

To find a Physician who accepts new Medicare patients, I might check with a hospital physician referral line. They may have such information. Friends and relatives might be a resource. If you see any specialists, the office of that specialist might have some ideas.

I also suspect that quite new Physicians may be most likely to accept new Medicare patients. I also suspect that very popular Physicians may be least likely to accept new Medicare patients.

Just my non-medical opinion, but that opinion is that there are big differences between "popularity" and "competence". Maybe, try to find an "unpopular" doctor who is very competent. My Primary Care physician (at Kaiser) is not very popular. I actually know two people who have switched away from her or who plan to do so shortly. I am, however, extremely happy with her and my opinion is that she is extremely competent and provides me with outstanding care and service. One friend who cannot stand her (my opinion and conclusion) doesn't like her because the Doctor told our friend that she was very overweight and needed to lose weight. In my opinion, a great number of patients love doctors who tell them what they want to hear and NOT what is medically "best". That is why I place almost zero confidence in patient reviews of Physicians. One local doctor, now in his 80's always gets 99% high ratings on Consumer Checkbook. Patients love him. He was my doctor 40 years ago, andd I did not think much of his overall competence back then.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by knpstr » Sun Mar 05, 2017 7:33 pm

Weird you're having so much trouble. It has been estimated 91% of all doctors accept medicare.

However, it is a problem with the "system" where Medicare (especially more with Medicaid) bully doctors on reimbursement.

Good luck! :beer
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dm200
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by dm200 » Sun Mar 05, 2017 7:40 pm

knpstr wrote:Weird you're having so much trouble. It has been estimated 91% of all doctors accept medicare.
However, it is a problem with the "system" where Medicare (especially more with Medicaid) bully doctors on reimbursement.
Good luck! :beer


I guess it depends on what "accepting Medicare" means. The issue here is "accepting new patients who are on medicare". In this area, it seems that most Physicians will accept Medicare on only existing patients, but not on new ones.

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knpstr
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by knpstr » Sun Mar 05, 2017 7:41 pm

dm200 wrote:
knpstr wrote:Weird you're having so much trouble. It has been estimated 91% of all doctors accept medicare.
However, it is a problem with the "system" where Medicare (especially more with Medicaid) bully doctors on reimbursement.
Good luck! :beer


I guess it depends on what "accepting Medicare" means. The issue here is "accepting new patients who are on medicare". In this area, it seems that most Physicians will accept Medicare on only existing patients, but not on new ones.


That's a good point, and likely why the percentage is so high!
Very little is needed to make a happy life; it is all within yourself, in your way of thinking. -Marcus Aurelius

HIinvestor
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by HIinvestor » Sun Mar 05, 2017 7:41 pm

We are starting to have this issue as H is now on Medicare after being on BCBS all these years. I'm still not eligible for Medicare for a few more years, so want to find some good docs before I age into it. My existing primary care doc is in his 60s. One of my younger docs is 49. I need to find a good internist who is younger, as I'm not sure how much longer my internist will be practicing and prefer to make the switch while I'm still on a plan they seem to like.
H and I each saw an ENT who is probably in his 50s, but we probably won't need to see him much longer. Our GI is also in his mid-50s, as is my OB. We have about 1/3 of the MDs in our state 65 or older. It's a growing concern. Just lost two of my favorite docs to retirement--one was 70 and the other late 50s.
I try to speak with like-minded people to find a GOOD doc--honesty and competence are important. I don't really just want someone who will say what they think I want to hear.

bklyn96
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by bklyn96 » Sun Mar 05, 2017 8:06 pm

Try https://www.zocdoc.com/ for a list of prospects—you can filter by specialty, zip code and insurance accepted. As others have said, just double-check the insurance they're working with. Good luck!

desiderium
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by desiderium » Sun Mar 05, 2017 8:18 pm

The issue here is "payer mix"

Most physicians and health care organizations indeed take medicare. But there is a significant gap between payments from medicare and private insurance for the same services. So for a given practice, the mix of government (medicare, medicaid, tricare) vs private health insurance is a key factor in net revenue. Unfortunately, this creates an incentive to try and manipulate this mix. If some groups are cherry picking patients with private insurance, others will need to follow as a defensive move for the business. The logical place to maintain or alter payer mix is at the front door; hence the regrettable reality is that many practices limit the number of new medicare patients they take on.

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Pajamas
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by Pajamas » Sun Mar 05, 2017 9:16 pm

1. Use Medicare's online database of providers that accept Medicare:
https://www.medicare.gov/physiciancompare/

2. Use a hospital's similar online "find a doctor" database that allows you to search by insurance provider or contact the person at the hospital who helps with such referrals.

3. Join a Medicare Advantage managed care plan and use their network.

You want providers who "accept Medicare assignment" so they won't bill you for what Medicare doesn't pay.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by drawpoker » Sun Mar 05, 2017 9:48 pm

It seems the OP's problem is two-fold - the failure of his retiring doctor to make any efforts to transition patients to a new practice; and finding doctors who are taking on new patients regardless of type of insurance.
Doing a database search to see who takes Medicare and who doesn't is going to be a waste of time. Plenty of PCPs will list Medicare and other insurance, then you discover they are not taking new patients at all when you call. :(
The problem is all over the U.S., not confined to the Midwest. It is compounded by the serious shortage of PCPs. New medical students are not going into PCP, family practice, whatever you care to call it in the same numbers anymore. They are seeking out specialties. The problem is getting so severe in some areas there are no PCPs at all anymore.
No doubt much of this is due to the crushing amount of student loan debt new doctors are saddled with. The quickest route to repaying all that debt is thru the more lucrative specialties. Google up on it.
If I were the OP, I would contact the county medical society and ask for a current list of doctors who are taking new patients. Then determine the Medicare status.
And I wouldn't waste any time. More and more doctors are announcing they are closing to new patients all the time.

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heartwood
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by heartwood » Sun Mar 05, 2017 10:32 pm

drawpoker wrote:
Doing a database search to see who takes Medicare and who doesn't is going to be a waste of time. Plenty of PCPs will list Medicare and other insurance, then you discover they are not taking new patients at all when you call. :(
The problem is all over the U.S., not confined to the Midwest.


I agree that a database search is problematic, both with Medicare and with private health plans. The information seems stale or just incorrect. True in PCP as well as some specialties. Resign yourself to calls to several offices to get the current status. We went through this in our home state a few years ago and about 2 years ago near our condo. There we were rejected by the office of a PCP but taken after a current patient spoke to the doctor about us. A very frustrating situation overall.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by toofache32 » Sun Mar 05, 2017 11:28 pm

desiderium wrote:The issue here is "payer mix"

Most physicians and health care organizations indeed take medicare. But there is a significant gap between payments from medicare and private insurance for the same services. So for a given practice, the mix of government (medicare, medicaid, tricare) vs private health insurance is a key factor in net revenue. Unfortunately, this creates an incentive to try and manipulate this mix. If some groups are cherry picking patients with private insurance, others will need to follow as a defensive move for the business. The logical place to maintain or alter payer mix is at the front door; hence the regrettable reality is that many practices limit the number of new medicare patients they take on.


This is true and the reason why when a new patient calls to make an appointment, many offices need your insurance info first to see when the next appt is available. Back when I used to be in-network with insurance, we would schedule the worst insurance plans on Monday morning at 8:00 because it was the least desirable time and the appointment most likely to have a no-show. In other words, we would put our worst paying plans in the spot most likely to no-show. Very Boglehead.

Commercial insurance has now started to trend downward in their payments closer to Medicare rates. We are almost at the point where there is no longer such a thing as "good insurance". I chuckle when patients come in and say "well I have very good insurance." I predict that most government patients (Medicare/Medicaid) will soon be relegated to institutional clinics (who are eligible to bill facility fees) since these plans pay less every year and no longer allow a private practice doc to pay the bills. This is already happening and serves many patients well. This is worsened by the fact that the Medicare population is statistically the sickest and requires the more time/care than younger patients. I dropped Medicare in my private because it was too expensive. Most people think we just send a bill to Medicare with codes on it and they pay. There are SO many bureaucratic, compliance, and reporting requirements involved with government plans that I had to hire additional staff to keep up with all of it...all or the privilege of accepting pennies on the dollar in payment. If they paid more then it could be worth chasing after. This is why I think only institutional settings (Kaiser, etc) can afford to stay with government plans in the future (with facility fees) and will only increase healthcare costs. Then we will complete our transition to a true 2-tiered healthcare system.

Jackson12
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by Jackson12 » Sun Mar 05, 2017 11:48 pm

dm200 wrote:
knpstr wrote:Weird you're having so much trouble. It has been estimated 91% of all doctors accept medicare.
However, it is a problem with the "system" where Medicare (especially more with Medicaid) bully doctors on reimbursement.
Good luck! :beer


I guess it depends on what "accepting Medicare" means. The issue here is "accepting new patients who are on medicare". In this area, it seems that most Physicians will accept Medicare on only existing patients, but not on new ones.

Yes, that is exactly what I mean. Our Doctor is now retired and finding a doctor who will accept new patients who are on Medicare has been a challenge . Not a problem if one is an existing patient. But that won't be our situation

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by Jackson12 » Mon Mar 06, 2017 12:01 am

drawpoker wrote:It seems the OP's problem is two-fold - the failure of his retiring doctor to make any efforts to transition patients to a new practice; and finding doctors who are taking on new patients regardless of type of insurance.
Doing a database search to see who takes Medicare and who doesn't is going to be a waste of time. Plenty of PCPs will list Medicare and other insurance, then you discover they are not taking new patients at all when you call. :(
The problem is all over the U.S., not confined to the Midwest. It is compounded by the serious shortage of PCPs. New medical students are not going into PCP, family practice, whatever you care to call it in the same numbers anymore. They are seeking out specialties. The problem is getting so severe in some areas there are no PCPs at all anymore.
No doubt much of this is due to the crushing amount of student loan debt new doctors are saddled with. The quickest route to repaying all that debt is thru the more lucrative specialties. Google up on it.
If I were the OP, I would contact the county medical society and ask for a current list of doctors who are taking new patients. Then determine the Medicare status.
And I wouldn't waste any time. More and more doctors are announcing they are closing to new patients all the time.


Our doctor did make a strong effort to transition us to a new doctor within the group practice. But then there was a major kerfluffle and the group broke Into segments. Some doctors, including the 2 recommended to us, moved far from our city, hours away. This was particularly surprising because the group practice had been solid for many years and I'd just assumed that when our doctor retired, a suitable colleague would be available. We've gotten names of trusted doctors from friends but none of their doctors are taking new patients. Some just recently stopped taking new patients. I know we'll find a doctor but I thought we might be missing some vital info in our search...some resource.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by goodenyou » Mon Mar 06, 2017 12:06 am

toofache32 wrote:
desiderium wrote:The issue here is "payer mix"

Most physicians and health care organizations indeed take medicare. But there is a significant gap between payments from medicare and private insurance for the same services. So for a given practice, the mix of government (medicare, medicaid, tricare) vs private health insurance is a key factor in net revenue. Unfortunately, this creates an incentive to try and manipulate this mix. If some groups are cherry picking patients with private insurance, others will need to follow as a defensive move for the business. The logical place to maintain or alter payer mix is at the front door; hence the regrettable reality is that many practices limit the number of new medicare patients they take on.


This is true and the reason why when a new patient calls to make an appointment, many offices need your insurance info first to see when the next appt is available. Back when I used to be in-network with insurance, we would schedule the worst insurance plans on Monday morning at 8:00 because it was the least desirable time and the appointment most likely to have a no-show. In other words, we would put our worst paying plans in the spot most likely to no-show. Very Boglehead.

Commercial insurance has now started to trend downward in their payments closer to Medicare rates. We are almost at the point where there is no longer such a thing as "good insurance". I chuckle when patients come in and say "well I have very good insurance." I predict that most government patients (Medicare/Medicaid) will soon be relegated to institutional clinics (who are eligible to bill facility fees) since these plans pay less every year and no longer allow a private practice doc to pay the bills. This is already happening and serves many patients well. This is worsened by the fact that the Medicare population is statistically the sickest and requires the more time/care than younger patients. I dropped Medicare in my private because it was too expensive. Most people think we just send a bill to Medicare with codes on it and they pay. There are SO many bureaucratic, compliance, and reporting requirements involved with government plans that I had to hire additional staff to keep up with all of it...all or the privilege of accepting pennies on the dollar in payment. If they paid more then it could be worth chasing after. This is why I think only institutional settings (Kaiser, etc) can afford to stay with government plans in the future (with facility fees) and will only increase healthcare costs. Then we will complete our transition to a true 2-tiered healthcare system.



Let me give a different spin on this. If you live in an area where the demographic of middle to upper-middle income patients, then you will likely find patients that can afford co-pays and huge deductibles. In areas where patients are living paycheck to paycheck, they have no money to meet their $6500 deductible and 20-30% co-pay. They are effectively uninsured. Government insured patients who have little or no out of pocket expenses nor super high deductibles have lower surgery cancellation rates. The problem is that the reimbursement for procedures to the surgeon is pathetic. So if you practice in areas with the working poor or lower middle class, those patients will also opt out of services as well. That is where the model of the employed physician comes in. Hospital overcharges, pays the physician RVU-based reimbursement and patient gets gouged.
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by jebmke » Mon Mar 06, 2017 12:07 am

This is why my budget assumptions don't include a reduction of our HC costs. I will probably get some short term benefit -- I start Medicare next year -- but my longer term assumption is that we will eventually convert back to conventional insurance at some point when the provider network gets too restrictive
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by toofache32 » Mon Mar 06, 2017 12:19 am

goodenyou wrote:
toofache32 wrote:
desiderium wrote:The issue here is "payer mix"

Most physicians and health care organizations indeed take medicare. But there is a significant gap between payments from medicare and private insurance for the same services. So for a given practice, the mix of government (medicare, medicaid, tricare) vs private health insurance is a key factor in net revenue. Unfortunately, this creates an incentive to try and manipulate this mix. If some groups are cherry picking patients with private insurance, others will need to follow as a defensive move for the business. The logical place to maintain or alter payer mix is at the front door; hence the regrettable reality is that many practices limit the number of new medicare patients they take on.


This is true and the reason why when a new patient calls to make an appointment, many offices need your insurance info first to see when the next appt is available. Back when I used to be in-network with insurance, we would schedule the worst insurance plans on Monday morning at 8:00 because it was the least desirable time and the appointment most likely to have a no-show. In other words, we would put our worst paying plans in the spot most likely to no-show. Very Boglehead.

Commercial insurance has now started to trend downward in their payments closer to Medicare rates. We are almost at the point where there is no longer such a thing as "good insurance". I chuckle when patients come in and say "well I have very good insurance." I predict that most government patients (Medicare/Medicaid) will soon be relegated to institutional clinics (who are eligible to bill facility fees) since these plans pay less every year and no longer allow a private practice doc to pay the bills. This is already happening and serves many patients well. This is worsened by the fact that the Medicare population is statistically the sickest and requires the more time/care than younger patients. I dropped Medicare in my private because it was too expensive. Most people think we just send a bill to Medicare with codes on it and they pay. There are SO many bureaucratic, compliance, and reporting requirements involved with government plans that I had to hire additional staff to keep up with all of it...all or the privilege of accepting pennies on the dollar in payment. If they paid more then it could be worth chasing after. This is why I think only institutional settings (Kaiser, etc) can afford to stay with government plans in the future (with facility fees) and will only increase healthcare costs. Then we will complete our transition to a true 2-tiered healthcare system.



Let me give a different spin on this. If you live in an area where the demographic of middle to upper-middle income patients, then you will likely find patients that can afford co-pays and huge deductibles. In areas where patients are living paycheck to paycheck, they have no money to meet their $6500 deductible and 20-30% co-pay. They are effectively uninsured. Government insured patients who have little or no out of pocket expenses nor super high deductibles have lower surgery cancellation rates. The problem is that the reimbursement for procedures to the surgeon is pathetic. So if you practice in areas with the working poor or lower middle class, those patients will also opt out of services as well. That is where the model of the employed physician comes in. Hospital overcharges, pays the physician RVU-based reimbursement and patient gets gouged.


Agreed. Which is why I said this model will only increase costs, but you explained it better.

Jackson12
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by Jackson12 » Mon Mar 06, 2017 9:10 pm

I greatly appreciate everyone's help. Latest experience: my spouse was seeing a specialist, put on steroids, and was in the middle of treatment with a younger doctor who we felt might stick around for awhile.

We just received a notice saying the doctor was pursuing "other avenues" as of March 3. A new medication had just been prescribed and now my husband is betwixt and between.

So we'll have to find a new specialist, one we trust, who we hope will not decide there is a whole different treatment needed. If so, he is back to Square One. We have gone through many such bumps in the road in the last few years.
]

.

HIinvestor
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by HIinvestor » Tue Mar 07, 2017 3:33 am

Ok, this thread has really gotten me motivated to find a new internist now, before I am on Medicare. I start asking around for YOUNGER internists that will stay in practice. I currently have some years before I am Medicare-eligible.

My own internist says his wife can't find an internist. Yikes!

Later this month, I'm flying to CA to meet a new doc because the one I've been seeing for 16 years is retiring. This new doc is pretty old but hopefully can refer me to one of his young protégées that he thinks will work with me.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by letsgobobby » Tue Mar 07, 2017 4:17 am

celia wrote:Note that everyone "takes" Medicare payment. (I will "take" it and I don't even work in the medical field! :happy ) In fact, everyone will likely "take" payment from anyone and apply it to your account--from your insurance, a relative, a neighbor, your dog,... What you want to know, instead, is if the doctor or medical group agreed to the price that Medicare says the service should be paid at.

this is not correct at all. doctors are not allowed to bill that way and no insurance contract, least of all medicare, allows that.

which leads to the situation we have today:

psychiatrists have the lowest rate of Medicare insurance acceptance of any specialty, around 50%. half don't accept it at all. you pay their cash rates, and you get reimbursed what you can from medicare, that is between you and Medicare. the psychiatrist may be kind enough to give you an itemized receipt for that purpose.

we only accept medicare parents from our own county, and they have their own longer wait list. but no one else in several counties accepts them at all.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by heartwood » Tue Mar 07, 2017 11:25 am

letsgobobby wrote:psychiatrists have the lowest rate of Medicare insurance acceptance of any specialty, around 50%. half don't accept it at all. you pay their cash rates, and you get reimbursed what you can from medicare, that is between you and Medicare. the psychiatrist may be kind enough to give you an itemized receipt for that purpose.


Our experience confirms the medicare acceptance problem. We can't find anyone in our area that accepts assignment. Our specialist "retired" awhile ago but continued to practice in a limited way for those that signed an agreement to pay her directly and not submit any bills to medicare. She sold her practice a few months ago and her replacement continues the practice: cash and agree to no filing for insurance.

If any doctor won't accept medicare, any supplemental insurance is prohibited from paying either. See what to know about private contracts below:

https://www.medicare.gov/your-medicare- ... nment.html
Last edited by heartwood on Tue Mar 07, 2017 11:28 am, edited 1 time in total.

letsgobobby
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by letsgobobby » Tue Mar 07, 2017 11:28 am

heartwood wrote:
letsgobobby wrote:psychiatrists have the lowest rate of Medicare insurance acceptance of any specialty, around 50%. half don't accept it at all. you pay their cash rates, and you get reimbursed what you can from medicare, that is between you and Medicare. the psychiatrist may be kind enough to give you an itemized receipt for that purpose.


Our experience confirms the medicare acceptance problem. We can't find anyone in our area that accepts assignment. Our specialist "retired" awhile ago but continued to practice in a limited way for those that signed an agreement to pay her directly and not submit any bills to medicare. She sold her practice a few months ago and her replacement continues the practice: cash and agree to no filing for insurance.

If any doctor won't accept medicare, any supplemental insurance is prohibited from paying either.

The problem is worse with office specialties. The vast majority of proceduralists have to have access to a hospital, and almost all hospitals take medicare, so most specialists take medicare one way or another. They may close their panels or have separate wait lists for medicare at varying times, however.

Since most psychiatrists do not affiliate with any hospital, they do not need to take medicare, and don't. Not going to go into the right or wrong of this, however, this is the reason the situation exists. It is a dire problem for geriatric psychiatry.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by kmurp » Tue Mar 07, 2017 11:35 am

Many hospitals employ physicians. Call your local hospitals for access.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by dm200 » Tue Mar 07, 2017 11:39 am

kmurp wrote:Many hospitals employ physicians. Call your local hospitals for access.


Even if not "employed" by hospitals, the hospital may have a Physician referral office. Years ago, due to insurance changes from employer, I needed both a Primary Care Physician (as did my wife) and an Endocrinologist - that accepted my employer insurance. The hospital referral line connected my with a Physician who was BOTH Primary care (Internal medicine) and Endocrinology.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by dm200 » Tue Mar 07, 2017 11:55 am

HIinvestor wrote:Ok, this thread has really gotten me motivated to find a new internist now, before I am on Medicare. I start asking around for YOUNGER internists that will stay in practice. I currently have some years before I am Medicare-eligible.
My own internist says his wife can't find an internist. Yikes!
Later this month, I'm flying to CA to meet a new doc because the one I've been seeing for 16 years is retiring. This new doc is pretty old but hopefully can refer me to one of his young protégées that he thinks will work with me.


Based on what I understand, what I read and what credible people tell me, a "Family Practice" Physician (either MD or DO - I regard them as "equivalent") may be just as good for Primary Care as an "Internist" (Internal Medicine). While I have always chosen "internists" for Primary Care, if I need to change, I would probably now equally consider a Family Practice Physician. Some Specialists (where it is a sub-speciality of Internal Medicine) also may see some patients for "Primary Care" as well. Again, for both Internal Medicine and Family Practice, consider Osteopathic Physicians (DO degree) equally with those having an MD.

Another possible factor (I have no factual idea) is that there might be more female physicians in adult Primary care that want and need more patients. [Although I am an "older" male, for Primary Care my last three Primary Care Physicians have been female and I am very happy with female Physicians]

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by cheese_breath » Tue Mar 07, 2017 12:21 pm

I was wondering if those having trouble finding doctors who accept Medicare would mind posting their approximate locations so us oldsters who might be considering relocating will know which ones to avoid.
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by toofache32 » Tue Mar 07, 2017 12:33 pm

letsgobobby wrote:The problem is worse with office specialties. The vast majority of proceduralists have to have access to a hospital, and almost all hospitals take medicare, so most specialists take medicare one way or another. They may close their panels or have separate wait lists for medicare at varying times, however.

Since most psychiatrists do not affiliate with any hospital, they do not need to take medicare, and don't. Not going to go into the right or wrong of this, however, this is the reason the situation exists. It is a dire problem for geriatric psychiatry.


Be careful because this is not always true, especially if the proceduralists are not employed by the hospital. I am a specialist surgeon who does procedures in hospitals. I am not in-network with Medicare so patients pay me a cash amount agreed upon in advance. The hospital is in-network so they can use their Medicare for the expensive part.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by toofache32 » Tue Mar 07, 2017 12:41 pm

heartwood wrote:
Our experience confirms the medicare acceptance problem. We can't find anyone in our area that accepts assignment. Our specialist "retired" awhile ago but continued to practice in a limited way for those that signed an agreement to pay her directly and not submit any bills to medicare. She sold her practice a few months ago and her replacement continues the practice: cash and agree to no filing for insurance.

If any doctor won't accept medicare, any supplemental insurance is prohibited from paying either. See what to know about private contracts below:

https://www.medicare.gov/your-medicare- ... nment.html


FYI...these are Medicare rules, not doctor rules. I am an "opted out" doctor with Medicare. If I treat a patient with Medicare, I am required to have the patient sign a form stating they know they cannot try to get Medicare to reimburse them.

https://www.cms.gov/Medicare/Provider-E ... avits.html

https://www.cahabagba.com/frequently-as ... -signs-it/

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by staythecourse » Tue Mar 07, 2017 1:14 pm

[quote="dm200"

Based on what I understand, what I read and what credible people tell me, a "Family Practice" Physician (either MD or DO - I regard them as "equivalent") may be just as good for Primary Care as an "Internist" (Internal Medicine). While I have always chosen "internists" for Primary Care, if I need to change, I would probably now equally consider a Family Practice Physician. Some Specialists (where it is a sub-speciality of Internal Medicine) also may see some patients for "Primary Care" as well. Again, for both Internal Medicine and Family Practice, consider Osteopathic Physicians (DO degree) equally with those having an MD. [/quote]

In the end a good primary care doctor is one that takes the onus of being the quarterback of the medical team and are accesible. It doesn't matter if they are MD, DO, male, or female. They make sure everyone (specialists) is on the same page, gets them involved as soon as they are needed, and are on top of the preventive care. The problem arises is even if you have a GREAT PCP what if the specialists they use don't take your insurance?

I always tell my patients you can tell within 5 minutes of taking a history if they either have no PCP or a bad one. PCP are not appreciated unless you don't have one or have a bad one. Unfortunately, as long as everything is runnin smoothly they are left unnoticed.

Good luck.
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by dpc » Tue Mar 07, 2017 1:27 pm

I would start calling local doctors and asking their staff about Medicare. No national database will ever be highly accurate.

There is a huge variation by locality. We lived in Corvallis OR for many years. The largest practice (Corvallis Clinic) will not accept new Medicare patients. I thought it was horrible attitude and still do. And doctors, please don't waste your time telling me your sob stories about Medicare, I've heard them.

We now live in a small town in WA. Very difficult to find a PCP of any kind, but they all accept Medicare, at least as far as I could determine.

If you need a new PCP, my advice is to start the process today, before you need one. I found the the local "Find A Physician" service to be useless.

Also, if you are considering relocation in retirement, do some research on availability of PCP, hospitals, and specialists. It should be a factor in your decision.
"Worrying is like paying interest on a debt that you might never owe" -- Will Rogers

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by staythecourse » Tue Mar 07, 2017 1:37 pm

dpc wrote:There is a huge variation by locality. We lived in Corvallis OR for many years. The largest practice (Corvallis Clinic) will not accept new Medicare patients. I thought it was horrible attitude and still do. And doctors, please don't waste your time telling me your sob stories about Medicare, I've heard them.


Frankly, doctors don't need to. There is no ethical or legal reason a doctor HAS to see a medicare patient or ANY patient they don't want to unless it is an emergency in an ER. Great thing or bad thing about democracy is the knife cuts both ways. When it helps folks they are thrilled about freedom and when it doesn't they want more regulation that is meant to benefit them.

As I always say if you aren't happy vote with your feet. Trust me if Clinic ABC or XYZ lost enough patients they would change their policy. They don't need to so why would they?

Good luck.

p.s. Actually it is funny you would write this on a financial forum. The analogy is doctor x taking on same risk of getting sued and cost of running operations from a medicare vs. commercial patient all the while decreasing the return (compensation). Would you buy a bond that has the same risk of default if it paid 50% less then another bond? Don't think so.
Last edited by staythecourse on Tue Mar 07, 2017 1:40 pm, edited 1 time in total.
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by dm200 » Tue Mar 07, 2017 1:37 pm

staythecourse wrote:[quote="dm200"Based on what I understand, what I read and what credible people tell me, a "Family Practice" Physician (either MD or DO - I regard them as "equivalent") may be just as good for Primary Care as an "Internist" (Internal Medicine). While I have always chosen "internists" for Primary Care, if I need to change, I would probably now equally consider a Family Practice Physician. Some Specialists (where it is a sub-speciality of Internal Medicine) also may see some patients for "Primary Care" as well. Again, for both Internal Medicine and Family Practice, consider Osteopathic Physicians (DO degree) equally with those having an MD.

In the end a good primary care doctor is one that takes the onus of being the quarterback of the medical team and are accesible. It doesn't matter if they are MD, DO, male, or female. They make sure everyone (specialists) is on the same page, gets them involved as soon as they are needed, and are on top of the preventive care. The problem arises is even if you have a GREAT PCP what if the specialists they use don't take your insurance?
I always tell my patients you can tell within 5 minutes of taking a history if they either have no PCP or a bad one. PCP are not appreciated unless you don't have one or have a bad one. Unfortunately, as long as everything is runnin smoothly they are left unnoticed.
Good luck.[/quote]

It has usually taken me several years, with 20/20 hindsight to conclude that my previous PCP is/was not good (medically). Although she was not old, she was (in my non-medical opinion) behind current information about various mattters. I have concluded (confirmed by 6 years hindsight) that my current PCP is very good. I am very, very happy with her. I always ask a lot of questions and she always seems to be appreciative and cooperative with my involvement in nearly all aspects of my health. When discussing issues, findings, etc., she often asks me, "What do you think?" I never see her in any "top doctors" lists, an internet search finds several terrible online patient reviews and I know two people personally that disliked her - and switched away. I am a bit puzzled. I have concluded, perhaps, that some patients may perceive her "demeanor" as much like a "ditzy" teenage girl (although she is now in her mid to late 30's) or that she may tell patients the truth (such as the patient is obese).

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by staythecourse » Tue Mar 07, 2017 1:47 pm

dm200 wrote:It has usually taken me several years, with 20/20 hindsight to conclude that my previous PCP is/was not good (medically). Although she was not old, she was (in my non-medical opinion) behind current information about various mattters. I have concluded (confirmed by 6 years hindsight) that my current PCP is very good. I am very, very happy with her. I always ask a lot of questions and she always seems to be appreciative and cooperative with my involvement in nearly all aspects of my health. When discussing issues, findings, etc., she often asks me, "What do you think?" I never see her in any "top doctors" lists, an internet search finds several terrible online patient reviews and I know two people personally that disliked her - and switched away. I am a bit puzzled. I have concluded, perhaps, that some patients may perceive her "demeanor" as much like a "ditzy" teenage girl (although she is now in her mid to late 30's) or that she may tell patients the truth (such as the patient is obese).


The reality is that what makes a person a good doctor (caring about the patient, working hard, coordinating care, figuring out how to get the patient involved with their care, i.e. ownership, etc...) is NOT what get good ratings on websites. What folks want to hear is they are great, doing great, there is free valet, convenient hours, latte machine in the waiting rooms, short wait times, close to shopping, etc...

The joke I make in private is many times the BEST specialists in a hospital are not the busy ones. The most successful ones in private are not necessarily the BEST but more the best at running a business. The know how to make patients and referral sources superficially happy.

Good luck.
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by dm200 » Tue Mar 07, 2017 3:07 pm

The reality is that what makes a person a good doctor (caring about the patient, working hard, coordinating care, figuring out how to get the patient involved with their care, i.e. ownership, etc...) is NOT what get good ratings on websites. What folks want to hear is they are great, doing great, there is free valet, convenient hours, latte machine in the waiting rooms, short wait times, close to shopping, etc...
The joke I make in private is many times the BEST specialists in a hospital are not the busy ones. The most successful ones in private are not necessarily the BEST but more the best at running a business. The know how to make patients and referral sources superficially happy.

Yes.
I am also convinced that the "interaction style" of the Physician is important in patient "satisfaction". I am convinced, for example, that my wife would be very unhappy with my Primary Care Physician.
Sometimes you need to help your Primary care physician deal with specialist recommendations/conclusions. Last year, for example, my Primary care physician received some recommendations from a Cardiologist about some conflicting test recommendations for me. She could not, directly, override that specialist. I "pushed back" and together, we decided that she would give me a referral (in person office visit) with another Cardiologist. She and I were, then, both happy and pleased with what that Cardiologist concluded - and my being his patient set everything straight on the medical record. Win - win.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by Jackson12 » Tue Mar 07, 2017 6:37 pm

staythecourse wrote:
dm200 wrote:It has usually taken me several years, with 20/20 hindsight to conclude that my previous PCP is/was not good (medically). Although she was not old, she was (in my non-medical opinion) behind current information about various mattters. I have concluded (confirmed by 6 years hindsight) that my current PCP is very good. I am very, very happy with her. I always ask a lot of questions and she always seems to be appreciative and cooperative with my involvement in nearly all aspects of my health. When discussing issues, findings, etc., she often asks me, "What do you think?" I never see her in any "top doctors" lists, an internet search finds several terrible online patient reviews and I know two people personally that disliked her - and switched away. I am a bit puzzled. I have concluded, perhaps, that some patients may perceive her "demeanor" as much like a "ditzy" teenage girl (although she is now in her mid to late 30's) or that she may tell patients the truth (such as the patient is obese).


The reality is that what makes a person a good doctor (caring about the patient, working hard, coordinating care, figuring out how to get the patient involved with their care, i.e. ownership, etc...) is NOT what get good ratings on websites. What folks want to hear is they are great, doing great, there is free valet, convenient hours, latte machine in the waiting rooms, short wait times, close to shopping, etc...

The joke I make in private is many times the BEST specialists in a hospital are not the busy ones. The most successful ones in private are not necessarily the BEST but more the best at running a business. The know how to make patients and referral sources superficially happy.

Good luck.
. Thanks. I'm not impressed by " perks" such as latte machines or expensive offices. In fact, they remind me all too well of our former AUM who had a lavishly decorated waiting area and lots of free snacks , gourmet coffee and teas, etc.

All of that came with a price...reflected in the fees. I only wish I'd learned that lesson earlier.

The good news is that we're on track for our retirement goals. We could have done better but if we'd waited much longer we could also have done far worse and would have been at significant risk of completely depleting our assets in old age.

This board helped up our learning curve and I'm grateful for thst.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by Jackson12 » Tue Mar 07, 2017 6:39 pm

dpc wrote:I would start calling local doctors and asking their staff about Medicare. No national database will ever be highly accurate.

There is a huge variation by locality. We lived in Corvallis OR for many years. The largest practice (Corvallis Clinic) will not accept new Medicare patients. I thought it was horrible attitude and still do. And doctors, please don't waste your time telling me your sob stories about Medicare, I've heard them.

We now live in a small town in WA. Very difficult to find a PCP of any kind, but they all accept Medicare, at least as far as I could determine.

If you need a new PCP, my advice is to start the process today, before you need one. I found the the local "Find A Physician" service to be useless.

Also, if you are considering relocation in retirement, do some research on availability of PCP, hospitals, and specialists. It should be a factor in your decision.
We're not waiting. We're researching now and using suggestions from this board to help us along the way.,

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by ram » Tue Mar 07, 2017 7:12 pm

cheese_breath wrote:I was wondering if those having trouble finding doctors who accept Medicare would mind posting their approximate locations so us oldsters who might be considering relocating will know which ones to avoid.

I am a physician practicing in the rural midwest. A physician from our group retired and relocated to central Florida. He has not been able to find a "satisfactory" PCP or specialist who would accept medicare. He now comes to me once a year and I treat him on the phone for the rest of the year.
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by Prudence » Wed Mar 08, 2017 10:06 am

jebmke wrote:This is why my budget assumptions don't include a reduction of our HC costs. I will probably get some short term benefit -- I start Medicare next year -- but my longer term assumption is that we will eventually convert back to conventional insurance at some point when the provider network gets too restrictive


Jebmke, does this mean you can drop off medicare (and not pay the premiums too) and buy your coverage from a private insurer like Aetna instead? What might the annual premium cost be for two people? $15,000, 20,000, 30,000,...?

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by Jackson12 » Wed Mar 08, 2017 10:51 am

Prudence wrote:
jebmke wrote:This is why my budget assumptions don't include a reduction of our HC costs. I will probably get some short term benefit -- I start Medicare next year -- but my longer term assumption is that we will eventually convert back to conventional insurance at some point when the provider network gets too restrictive


Jebmke, does this mean you can drop off medicare (and not pay the premiums too) and buy your coverage from a private insurer like Aetna instead? What might the annual premium cost be for two people? $15,000, 20,000, 30,000,...?


My sister and her husband, with just a few years to go before they're eligible for Medicare, pay $1200 a month for a high deductible plan - and they're in good health.

This is one reason why my spouse is fighting to keep working till age 70 - but the odds are not great. We have a very good pre-tax plan with a decent employer match ( they pay 1/2 of the premiums ) .

I still have to make several calls a week to let the insurer know that they've coded something incorrectly or that we're expected to pay more than noted in our benefits plan.,

Most recently, one of us was put on a medication which would costs upwards of $1000 a month ...except that we qualified for financial assistance.And this med was not even for a serious condition !

To coordinate all the moving parts of getting a specialty drug approved, get a card to lower costs when filling the prescription , submit the paperwork, and make calls to ensure our Doctor responded to insurance requests for info before the deadlines expired took many hours a week, much of it on the phone ( often on hold for over an hour).

This is par for the course. I wonder if it will be the same with Medicare?

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by randomguy » Wed Mar 08, 2017 10:58 am

Prudence wrote:
jebmke wrote:This is why my budget assumptions don't include a reduction of our HC costs. I will probably get some short term benefit -- I start Medicare next year -- but my longer term assumption is that we will eventually convert back to conventional insurance at some point when the provider network gets too restrictive


Jebmke, does this mean you can drop off medicare (and not pay the premiums too) and buy your coverage from a private insurer like Aetna instead? What might the annual premium cost be for two people? $15,000, 20,000, 30,000,...?


I don't know if you can drop medicare, but you could definitely do a hybrid approach. Pay cash/sign up for a concierge med plan for primary care (i.e. generally not the super expensive stuff. Call it 5-10k/year) and use medicare for hospitals/specialists (where you can start racking up 100k bills in a hurry).

At some point if you live in a medical desert, you have to think about moving. It definitely should be way up on the list if you are thinking about moving for retirement.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicare

Post by dm200 » Wed Mar 08, 2017 11:12 am

Even now, after presumably the gap between Traditional Medicare funding and Medicare Advantage Plans has closed, I am puzzled by how many Physicians (in this area) do not accept Medicare (either at all or new patienst) and the heavy advertising and competition from (at least two - Kaiser and Humana) Medicare Advantage (or the similar Medicare Cost) Plans. Obviously, these promoted and advertised plans must be doing wekk (or at least OK) financially.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by jebmke » Wed Mar 08, 2017 11:51 am

randomguy wrote:
Prudence wrote:
jebmke wrote:This is why my budget assumptions don't include a reduction of our HC costs. I will probably get some short term benefit -- I start Medicare next year -- but my longer term assumption is that we will eventually convert back to conventional insurance at some point when the provider network gets too restrictive


Jebmke, does this mean you can drop off medicare (and not pay the premiums too) and buy your coverage from a private insurer like Aetna instead? What might the annual premium cost be for two people? $15,000, 20,000, 30,000,...?


I don't know if you can drop medicare, but you could definitely do a hybrid approach. Pay cash/sign up for a concierge med plan for primary care (i.e. generally not the super expensive stuff. Call it 5-10k/year) and use medicare for hospitals/specialists (where you can start racking up 100k bills in a hurry).

At some point if you live in a medical desert, you have to think about moving. It definitely should be way up on the list if you are thinking about moving for retirement.

I don't know if you can drop Medicare or not. I'm still a few months away so I need to check.

We have plenty of physicians who accept Medicare in our area but the quality is low, especially for things like cardiac care. The nearest hospital with acute cardiac care is over an hour away in good traffic. Two+ if it is a bad beach traffic day. But I think the places where Medicare might start shedding coverage is exactly in the urban areas where the quality of the care is high. These markets have the wealth and critical mass to support non-Medicare networks.
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Re: Searched forum, unsuccessful, how to find doctors who take Medicare

Post by toofache32 » Wed Mar 08, 2017 12:03 pm

dm200 wrote:Even now, after presumably the gap between Traditional Medicare funding and Medicare Advantage Plans has closed, I am puzzled by how many Physicians (in this area) do not accept Medicare (either at all or new patienst) and the heavy advertising and competition from (at least two - Kaiser and Humana) Medicare Advantage (or the similar Medicare Cost) Plans. Obviously, these promoted and advertised plans must be doing wekk (or at least OK) financially.


I might be misunderstanding, but I think you're comparing independent physicians with employed physicians. Independent physicians are not eligible to charge facility fees, but employed physicians (Kaiser) do. This is why I think Medicare and Medicaid is shifting towards only being accepted in institutional settings where facility fees can be charged. This increases costs of healthcare.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicare

Post by dm200 » Wed Mar 08, 2017 12:30 pm

toofache32 wrote:
dm200 wrote:Even now, after presumably the gap between Traditional Medicare funding and Medicare Advantage Plans has closed, I am puzzled by how many Physicians (in this area) do not accept Medicare (either at all or new patienst) and the heavy advertising and competition from (at least two - Kaiser and Humana) Medicare Advantage (or the similar Medicare Cost) Plans. Obviously, these promoted and advertised plans must be doing well (or at least OK) financially.

I might be misunderstanding, but I think you're comparing independent physicians with employed physicians. Independent physicians are not eligible to charge facility fees, but employed physicians (Kaiser) do. This is why I think Medicare and Medicaid is shifting towards only being accepted in institutional settings where facility fees can be charged. This increases costs of healthcare.


I am in the Kaiser medicare plan, but several friends and acqaintences are in the Humana Medicare (Advantage) plan. As best I understand, those in the Humana plan see Physicians (independent Physicians as you describe them) in those Physician's offices just like other patients - with all sorts of insurance coverages. I do not know the details of Kaiser medicare payments, but I believe it is Kaiser (and not the individual Physicians) that receive the Medicare paymewnts and reimbursements.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by S&L1940 » Wed Mar 08, 2017 12:31 pm

Pajamas wrote:1. Use Medicare's online database of providers that accept Medicare:
https://www.medicare.gov/physiciancompare/

2. Use a hospital's similar online "find a doctor" database that allows you to search by insurance provider or contact the person at the hospital who helps with such referrals.

3. Join a Medicare Advantage managed care plan and use their network.

You want providers who "accept Medicare assignment" so they won't bill you for what Medicare doesn't pay.

3. it is my understanding that in an Advantage group you are automatically "locked" into their network in order to receive the benefits

to pay off the balance of covered costs (in traditional Medicare) is the reason to carry Medigap insurance - although billing denied by Medicare can be your full obligation unless you challenge the provider

Edited once
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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by dm200 » Wed Mar 08, 2017 1:04 pm

S&L1940 wrote:
Pajamas wrote:1. Use Medicare's online database of providers that accept Medicare:
https://www.medicare.gov/physiciancompare/
2. Use a hospital's similar online "find a doctor" database that allows you to search by insurance provider or contact the person at the hospital who helps with such referrals.
3. Join a Medicare Advantage managed care plan and use their network.
You want providers who "accept Medicare assignment" so they won't bill you for what Medicare doesn't pay.

3. it is my understanding that in an Advantage group you are automatically "locked" into their network in order to receive the benefits
to pay off the balance of covered costs (in traditional Medicare) is the reason to carry Medigap insurance - although billing denied by Medicare can be your full obligation unless you challenge the provider
Edited once


Yes. In MA (and the similar Medicare Cost) plans - you must use that plan's Physicians or Providers. However, you have no problem in finding a Physician who "accepts" Medicare, though. Usually (but not always), as well, there are multiple Physicians to choose from if, for some reason, you do not like some of the Physicians. Yes, it is also the case that you do not (and cannot get) a Medigap or Supplement, so things like copays and charges (up to the Out of Pocket annual limits) are the patient's responsibility. Usually there are multiple choices in these plans of higher monthly premiums for lower costs of care.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by randomguy » Wed Mar 08, 2017 1:04 pm

jebmke wrote:I don't know if you can drop Medicare or not. I'm still a few months away so I need to check.

We have plenty of physicians who accept Medicare in our area but the quality is low, especially for things like cardiac care. The nearest hospital with acute cardiac care is over an hour away in good traffic. Two+ if it is a bad beach traffic day. But I think the places where Medicare might start shedding coverage is exactly in the urban areas where the quality of the care is high. These markets have the wealth and critical mass to support non-Medicare networks.


They also have a surplus of doctors/hopsitals (relative to rural areas) that need patients. Places don't take low paying patients out of the goodness of their hearts. They take them to make ends meet. Better to get 60/visit instead of having an empty slot. Long term how everything works out is hard to say. So far urban areas have done better with medical access than rural. Wealth people can opt out (concierge med is popular) but there are enough middle class and the liek to keep the system functioning. Generally the urban areas get the people from better medical schools while rural areas tend to get more from local schools. How that relates to quality of care is hard to say. MOst of the time the worst doctor is good enough. But when you need a good doctor, you really need a good doctor. The sad part is that it is tough for good doctors to get paid a ton more than bad ones in things like primary care.

Choosing to live 1 hour from the nearest acute cardiac hospital seems like it is a choice independant of insurance (unless there is one 15 mins away that doesn't take medicare). I have no clue what a choice like that does to life expectancy.

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Re: Searched forum, unsuccessful, how to find doctors who take Medicsre

Post by toofache32 » Wed Mar 08, 2017 1:26 pm

randomguy wrote:
They also have a surplus of doctors/hopsitals (relative to rural areas) that need patients. Places don't take low paying patients out of the goodness of their hearts. They take them to make ends meet. Better to get 60/visit instead of having an empty slot. Long term how everything works out is hard to say. So far urban areas have done better with medical access than rural. Wealth people can opt out (concierge med is popular) but there are enough middle class and the liek to keep the system functioning. Generally the urban areas get the people from better medical schools while rural areas tend to get more from local schools. How that relates to quality of care is hard to say. MOst of the time the worst doctor is good enough. But when you need a good doctor, you really need a good doctor. The sad part is that it is tough for good doctors to get paid a ton more than bad ones in things like primary care.


This is one of the reasons I eventually dropped all medical insurance as a surgical specialist. Experience is not valued. Now I'm completely out-of-network. It helps that I do a surgery that only 3 other surgeons in the USA perform.

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