Which doctors take Medicare? Where do I find a list of Medicare approved doctors that are near me? How do I know if my doctor is in network? Do I need a referral to see a specialist? Can I keep my current doctors or will I need to change? Georgia Medicare Plans answers your questions.
Good news!
When you have original Medicare there are no networks, referrals are not required, you do not need to pick a PCP (primary care physician)
When choosing a Medicare plan you should always ask your current doctors if they participate in Medicare. According to a recent survey, 98% of primary care physicians accept original Medicare.
Table of Contents
Yes, it is True, MOST Doctors Take Medicare, but Some Opt Out
What can you do if your doctor will no longer accept Medicare? Do you look for a new doctor or pay cash?
The message above is extreme . . . and more likely an exaggeration . . . if you read her posts. This one in particular references things that happen in a MANAGED CARE plan . . . such as an HMO or PPO.
Leverages a $50 penalty against me when my patients accidentally go to out-of-network labs.
Charges me hundreds of dollars of “membership fees” before I’m allowed to see their patients.
Assigns me patients who have not selected me as their doctor.
Insurance companies have done all of these things to me. My choice to end my relationships with abusive insurance companies will never impact the quality of medical care that you’ll receive from me. I will always care for you even if I do not care for your insurance company.
ALL of the above complaints are what can be expected in an HMO or PPO Advantage care INSURANCE plan.
Medicare is NOT insurance . . . it is a taxpayer funded, health care reimbursement plan, that does not assign patients to a doctor they do not want . . . does not penalize the doctor, OR patient, if they go out of network (original Medicare does NOT have networks . . . and Medicare does not charge “membership fees” to providers.
Are Concierge Doctors an Option?
Some medical practices, including those who have opted out of Medicare, now see patients on a “cash only” basis.
This type of medical office is typically primary care only, although some may incorporate a few specialists (such as dermatology) in the mix. A concierge practice usually offers extra benefits such as valet parking, “no wait” appointments, telehealth consults and so forth.
Most do not accept ANY insurance plan and will not bill Medicare or your insurance plan. I have a video that addresses some of the Problems with Concierge Medicine and Medicare.
Are There Doctors Near Me That Accept Medicare Patients?
Regardless of whether you live in a large metro area or a small, rural town, it is almost always possible to find a provider that accepts original Medicare. Any doctor that takes Medicare will ALSO accept your Medigap (Medicare supplement) plan, regardless of the issuing carrier.
By choosing a doctor who accepts Medicare, you’ll ensure you are charged the negotiated and acceptable rate. Your doctor’s office will also bill Medicare for your visit. In most cases, a doctor who accepts Medicare will also wait to hear back from Medicare before asking you to pay any cost difference if appropriate. https://www.healthline.com/health/medicare/doctors-that-accept-medicare-near-me
You can also use the Medicare Physician Finder to search for Medicare participating providers near you.
How do I find a doctor who accepts Medicare assignment?
The Medicare Physician Finder will help you identify providers that accept Medicare assignment.
Will my doctor accept my Medicare Advantage plan?
The Medicare Physician Finder does not have information about HMO and PPO network providers. You will need to ask your Medicare Advantage plan to help you identify par providers. Using non-par providers can result in higher OOP (out of pocket) costs to you.
What Does Medicare Physician Compare Offer?
Physician Compare only lists professionals that accept Medicare. Although some may also accept Advantage plans, it does not have information about which carriers and plans the may accept. PPO plans are much different from HMO plans, and you may not have access to ALL your doctors if you have a managed care plan.
Should I ask my doctor about Medicare? Will they accept ALL Medicare plans? How about original Medicare? Are all my doctors in network? Is Medicare and a supplement plan better than Medicare Advantage? How much more will I pay for using an out of network doctor?
Ask your doctor if Medicare covers your existing medications and treatment. Based on your medical history, what type of plan is better for you? Original Medicare and Medigap or a PPO Advantage plan?
Where Can I Learn More About Doctors that Accept Medicare?
Medicare information. Our videos help you to understand about Medicare options. You have questions, I have answers. Medicare supplement plans, Medicare Advantage vs Medicare supplement. Medicare Part A, Medicare Part B. Which Medicare plan is BEST? How to change Medicare plans? Medicare supplements plan G information and rates. Which Medicare options are best? What is original Medicare? What are Medicare basics? Turning 65 Medicare? Help understanding Medicare. Medicare explained.
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