Did moving to Medicare at 65 impact your access to choice of doctors?

[Tree-dweller]

As I turn 65 and transition to Medicare later this year, I’m curious if anyone already there discovered that he or she encountered many health care providers who have opted out of accepting Medicare. A 2013 annual reportby the Medicare Payment Advisory Commission, an independent congressional agency, shows that 28% of beneficiaries seeking a new primary-care physician the previous year had trouble finding one who accepted Medicare. As someone whose primary care doc is retiring, should I expect difficulty finding a new one accepting Medicare?

 

[Walt34]

I didn't have any trouble but I'd been seeing the same primary care doctor for 12 years before that. And I'm fortunate to have very good secondary insurance.

 

[youbet]

1. There is a difference between "accepting Medicare" and "accepting Medicare assignment." Make sure you know the difference.

2. Is your current doc who is retiring part of a practice? Can you just stay with the practice? Does that practice accept Medicare assignment?

3. Just because 28% had trouble finding a primary-care physician who accepted Medicare assignment doesn't mean they didn't eventually find one. I bet most did.

4. DW and I have been on Medicare (me) and Medicare Advantage (DW) for over five years. Absolutely no trouble finding docs including specialists (DW is fighting cancer).

As someone whose primary care doc is retiring, should I expect difficulty finding a new one accepting Medicare?

5. You can really answer the question yourself with minimal effort. Call current doc's practice and ask what their plans are for transitioning doc's patients when he retires. Then ask if they accept Medicare assignment as you'll be changing insurance from your current plan to Medicare shortly.

 

[Bamaman]

I am in traditional Medicare and have not had any doctor problems since I have a good supplement thru ex Megacorp.

Let me warm you about the Medicare Advantage Plans. Not every hospital accepts Advantage. The big hospital North of me doesn't accept it, and that is where I would want to go for any rea!ly serious ailments.

When this hospital opted out, that meant 1700 physicians and a Nurse Practioners and hospitals owned and controlled by them in 6 states had to refer patients to other doctors and lesser quality hospita!s not in patient's home towns. It has been a big hassle.

 

[youbet]

I am in traditional Medicare and have not had any doctor problems since I have a good supplement thru ex Megacorp.

Having a supplement doesn't help finding a doc when you're on Medicare, but it helps pay the doc! If the doc accepts Medicare assignment, you're in. If he doesn't, you're out. If you have a supplement, at least a type F, the supplement pays the 20% Medicare doesn't pay. If you don't have a supplement, you pay the 20%. It doesn't matter to the doc.

Let me warm you about the Medicare Advantage Plans. Not every hospital accepts Advantage.

I think you have this a bit confused. Not all Medicare Advantage plans are the same. Some have very narrow networks. Some have broad networks. Some (like my DW's) are accepted wherever traditional Medicare is accepted. If a hospital accepts traditional Medicare, it accepts her particular Medicare Advantage plan. (DW's Medicare Advantage plan is a group plan with UHC and sponsored by her gov't ex-employer.) Many people get this confused. But, you do need to be careful when shopping Medicare Advantage plans that you get one which has all the docs and hospitals you'd be interested in within their network. We've been told that Advantage plans like hers whose network consists of all hospitals and docs who accept Medicare are not common.

 

[wmc1000]

Here in central Indiana, it has mostly only been "concierge" docs in private practices who have opted not to accept traditional Medicare assignment.

 

[wmc1000]

Fewer docs opting out in 2017 per this article:

http://www.modernhealthcare.com/article/20180130/NEWS/180139995

 

[braumeister]

No change for me. AFAIK, the vast majority of doctors accept Medicare.

But also be aware of point #1 in youbet's post (post #3 above).

 

[harllee]

I have had some difficulty finding doctors that are taking new patients and also accept medicare. One of my favorite doctors does not accept Medicare at all so I had to quit using her. Plenty of doctors accept medicare in my area but only a few of those are accepting new patients.

 

[CardsFan]

But also be aware of point #1 in youbet's post (post #3 above).

Please explain the difference, to us that still have a few more years before medicare.

 

[Chuckanut]

I had trouble with a podiatrist that my GP referred me to in order to get a seriously ingrown toe nail removed. The foot doctor was not taking new Medicare patients, but they gave me the name to another one in the same area who was taking new Medicare patients.

Eventually, I found out that my Dermatologist would do the same procedure for about 1/2 the price and I knew him to be a good surgeon since he had done some minor surgery on me a year ago and it turned out very well. Needless to say I chose my Dermatologist and I now have 10 happy toes

 

[braumeister]

Please explain the difference, to us that still have a few more years before medicare.

This page explains it.

 

[Dtail]

Moved to Florida. As expected, many doctors accept Medicare for my DGF.

 

[davebarnes]

I loves HMOs

Nope.
Kaiser.

 

[Scrapr]

Nope.
Kaiser.

Yep. Me too. Just another patient in the machine. We have had some great docs with Kaiser. Only a couple duds. And it's easy to switch if things aren't going well

But I have start figuring stuff out as I'm turning 62 in a couple months

 

[marko]

Here in central Indiana, it has mostly only been "concierge" docs in private practices who have opted not to accept traditional Medicare assignment.

My concierge doc doesn't accept Medicare because he doesn't accept any insurance; Medicare or otherwise. You pay him a monthly and he sees you whenever you need him.

 

[CardsFan]

This page explains it.

Thanks. I will keep this in mind when the time comes.

 

[W2R]

I think that all (or almost all?) Americans over age 65 are required to have Medicare.

I have had no problems so far with Medicare as primary and BCBS federal retiree insurance as secondary. Possibly this could be a bigger problem in HCOL areas where doctors do not want their income to be limited to the low amounts that Medicare will pay.

 

[youbet]

I think that all (or almost all?) Americans over age 65 are required to have Medicare.

Not exactly. I believe you'll automatically be put on Part A when you turn 65, but I believe you can contact them and be taken off. Part B is strictly voluntary and you can sign up or not. So, I think that no Americans are required to have Medicare.

But I like my Medicare and am thankful for it! But you're not "required" to have it.

 

[W2R]

Not exactly. I believe you'll automatically be put on Part A when you turn 65, but I believe you can contact them and be taken off.

Really? Oh - - sorry! I didn't know that. I don't know anyone my age who is not on Medicare.

 

[youbet]

I don't know anyone my age who is not on Medicare.

I don't know anyone 65 or over that isn't on Medicare either, at least Part A. It's a good deal. But I don't think it's mandatory. What is mandatory is that you must pay into Medicare during your working years.

I do know one person who did not sign up for Part B or Part D.

 

[youbet]

My concierge doc doesn't accept Medicare because he doesn't accept any insurance; Medicare or otherwise. You pay him a monthly and he sees you whenever you need him.

Is the idea that if you require something expensive like surgery or chemo, then you'd use insurance to pay for the surgeon/oncologist/hospital? Your liability to the concierge doc is his/her annual fee for office visits and referrals? Or is there some way that your uninsured costs from the concierge doc can skyrocket if you have expensive health problems?

 

[Amethyst]

Mr. A. had to apply for Part A. It was not automatic.

 

[MichaelB]

Not sure, but I think Medicare A is automatic when one has already signed up for Social Security. Otherwise, one needs to enroll.

 

[Amethyst]

That would explain it...neither of us qualifies for SS, since we paid into a civil service pension instead.

Not sure, but I think Medicare A is automatic when one has already signed up for Social Security. Otherwise, one needs to enroll.