Medicare DQOTD: GP Gatekeeper?

[Midpack]

After decades of Corp healthcare where a GP gatekeeper referral was required for almost any non-emergency event, hows that work with Medicare (new to me)? Do I still need to see a GP first, or can I go directly to a dermatologist for example? From what I gather I don’t need a gatekeeper with Medicare, but I haven’t found that directly stated yet.

[REWahoo]

Quote:

Originally Posted by Midpack After decades of Corp healthcare where a GP gatekeeper referral was required for almost any non-emergency event, hows that work with Medicare (new to me)? Do I still need to see a GP first, or can I go directly to a dermatologist for example? From what I gather I don’t need a gatekeeper with Medicare, but I haven’t found that directly stated yet.

If you are on regular Medicare you can go directly to any doctor/specialist that you choose - no gatekeeper. If you choose a Medicare Advantage plan you will likely be limited in what doctor you can see and may be required to have a GP referral, but each MA plan is different.

[Sarah S]

Original medicare you do not need a referral to have the visit paid. Some specialists may require you to be referred in a medical sense- someone medical has to say you need their services because they don’t want to waste time

[Midpack]

Great, thanks. I’m on original + Medigap.

[NoMoreJob]

I've had specialists ask who referred me and I just give them my PCPs name. He never refers me to a specific specialist anyway but gives me a big list instead. I've never had it questioned when I've given his name and I know that some of the specialists have no idea who he is. I think that asking may be more to insure that the details of my treatment is sent to him.

I really like the fact that I can choose my own specialists with no hassle.