Do all doctors take Medicare? The answer may surprise you. Which Medicare plans are widely accepted by Georgia doctors? Can my doctor refuse to take my Medicare plan? What happens then? How do I find physicians that take Medicare?
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Do all Georgia Doctors take Medicare?
The short answer is no. A better answer is, most doctors DO accept Medicare patients. But some Georgia medical practices are not currently taking new Medicare patients or may have a waiting list for new patients.
This is especially true if you have a Medicare ADVANTAGE plan.
Finding a Medicare Doctor
Your challenge is even more diverse when you break it down by:
- Doctors that take Medicare patients
- Physicians that accept Medicare assignment
- Doctors that do not participate in Medicare
- Medical practices that participate in Medicare but not Medicare Advantage
The good news is, most doctors participate in Medicare and do treat Medicare patients. About 96% of physicians that do take Medicare also accept assignment of benefits. Doctors that may opt out of Medicare are usually in the mental health field and some chiropractic doctors.
Most Accept Original Medicare Patients
In Georgia about half the physicians accept Medicare Advantage patients and most of them will only participate in a few plans but not all. The number dwindles down further when you have an Advantage HMO plan.
Doctors can refuse to accept your Medicare Advantage plan if they are not in network. If that happens they are still required to file with original Medicare and then wait on Medicare to pay you. In these situations they are allowed to bill excess charges.
When you have an Advantage plan make sure you understand the rules and how your liability is determined.
Finding physicians that participate in Medicare is relatively easy. If you Google “doctors that take Medicare” you will find an array of choices including other search engines and referral services. My advice is to go direct to the source, Medicare.gov.
The Medicare physician finder is a useful tool for finding doctors, hospitals, DME suppliers and other medical facilities in your area that participate in original Medicare.
When you just use Google you will find doctors that
- advertise locally on Google
- are registered with referral services
- are listed on Medicare plan sites
- may be reviewed by Yelp or Angies List
While some of those sites may be useful the Medicare physician finder tool has been the most helpful for my clients.
Is Medicare Supplement Expensive?
Medicare supplement plans can be quite affordable and do not require network participation.
We NEVER Sell Your Information
New to Georgia
Jean moved from California to Georgia a few months before turning 65. She had Kaiser in California but her plan offered only limited coverage in Georgia where she was considered a “visitor”. Jean had some medical conditions that required a specialist and she wanted freedom of choice when it comes to finding a doctor.
This meant saying no to Medicare Advantage plans with their limited doctor choice, high out of pocket and yearly changes in benefits.
Jean is living on a fixed income and needs a way to budget for her care. Original Medicare and a Medicare supplement plan was exactly what she needed.
No Selling Please
How do you find answers to your Medicare questions WITHOUT getting a SALES PITCH?
Everyone wants to talk. No one wants to listen and answer . . . until you BUY SOMETHING.
Something you don’t want, don’t need and can’t afford.
When Jean contact me she was living with local relatives and didn’t want a bunch of insurance sales people coming to see her. At Georgia Medicare Plans we believe in personal consultation in the privacy of your home. We know that many people do not feel comfortable having strangers in their home and several do not want to travel to see us. I employ a client centered focus and believe in respecting your “space”. That is why all of our clients receive information and advice by phone and email. There is never any pressure to make a decision and you move forward based on your time frame once you are comfortable you understand the Medicare system and can afford the coverage you want.
Find a Medicare Plan Accepted by GA Doctors
I spent several hours on the phone discussing her needs and looking at options. Then I emailed Jean information based on the benefits she needed and plans that fit her budget. I also provided her with details on Medicare Extra Help, a service that can reduce her out of pocket expenses for medication.
After reviewing all her options Jean selected Medicare supplement plan N from a carrier with a long history in covering Medicare clients. While most agents that talked with Jean pushed Medigap plan F she knew that plan was not going to fit her budget.
Blue Cross wanted $176 for plan F and United Health Care (AARP) even more at $180. Plan F with Continental (Aetna) had the lowest premium at $141. But that was still too much.
We talked about the differences in plan F, G and N and how each plan was more affordable due to cost sharing. Plan N coverer her Medicare Part A expenses at 100% but does require her to pay the Part B annual deductible + a $20 copay for doctor visits.
Jean’s premium for plan N was $86 from New Era insurance company. Even with the cost sharing she still cut her premium in half vs. most of the plan F plans.
Finding a Medicare physician
As mentioned above, the Medicare physician finder is the most reliable tool in your arsenal for finding doctors in your area. Once you find some doctors that fit your needs, make some phone calls.
Here is what you need to know.
- Does the doctor participate in Medicare?
- Are they taking new patients?
- If you have an Advantage plan, are they CURRENTLY participating in that plans network?
- Do they accept Medicare assignment?
- Does the doctor require up front payment for Medicare patients?
Most doctors DO participate in Medicare and most take assignment. A medical practice that accepts Medicare assignment means
- you never have to pay up front for Medicare covered services
- you never have to file claim forms with Medicare
- Medicare and your supplement plan will pay your doctor direct, not you
- your doctor can never bill you for excess charges
Doctors that take Medicare is easy. But finding an affordable Medigap plan that meets your needs and budget can be difficult. In some parts of Georgia you may only have half a dozen Advantage plan choices and many of them may not include your doctor or hospital in their network.
However there are more than 170 Medicare supplement plans statewide. Finding a plan with our help is as simple as getting a personalized Medigap quote in the privacy of your home, picking up the phone or sending us an email.
Let us know how we can help.
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