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  • Bob Vineyard

Doctors Take Medicare and are Near Me

Bob Vineyard · March 11, 2022 · Leave a Comment

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.

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?

Doctors take Medicare

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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Medicare Adds Telehealth Consults

Bob Vineyard · December 18, 2020 · Leave a Comment

Telehealth doctor phone consults covered by Medicare. Concern over the COVID-19 “pandemic” prompted Medicare to respond by allowing doctor “visits” by telephone.

Medicare covers telehealth and telemedicine services

What is Telehealth / Telemedicine?

Medicare telemedicine services include office visits, psychotherapy and other consultations. Real time two-way communication (video and audio) allows patient and doctor to have “FaceTime”.

With telemedicine you can receive medical advice anytime, anywhere, without leaving your home.

What if your doctor is unavailable when you have a medical crisis? The ability to use telehealth services is beneficial.

Telemedicine is Not New

Doctor/patient phone consults are not new. In home visits, especially in rural areas, are virtually impossible.

Telehealth services have existed since the 1950’s with the use of landlines. As phone technology improved cellular “smartphones” and computer tablets like iPads have expanded the ability to communicate.

New technology allow the doctor and patient to talk and see each other at the same time. This “Star Trek” approach to health care allows us to go where no one has gone before.

Insurance is not necessary to access services like GoodRx Care but it is nice to know that your red, white and blue Medicare card works for you.

Is Telehealth a Viable Business Model?

Telehealth is a two edged sword.

On one hand patients have access to REAL doctors who offer “FaceTime” type consults. Patients and doctors exchange information about overall health, aches, pains and concerns.

Consuling a real doctor with a medical degree is better than asking Dr. Google about symptoms.

Beyond the question of quality of care physicians will have to ask if this is a viable business model? Will telemedicine provide sufficient revenue to allow practices to survive?

Close to half of doctors are now using telehealth to treat patients as the COVID-19 pandemic changes practice patterns and how physicians deliver care.

That’s up from 18% of physicians using telemedicine two years ago, based on The Physicians Foundation’s “2018 Survey of America’s Physicians.” – Fierce Healthcare

So the good news is, more doctors are offering remote access consults. But the bad news?

Some medical practices are seeing a 60% dropoff in patient visits and a 55% reduction in revenue. Medical support staff is being laid off or having a reduction in hours.

Telemedicine is a short term solution to health care with a long term impact that is not workable.

A substantial minority of physicians (32%) said they plan to change practice settings, leave patient care roles, temporarily shut their practices or retire in response to COVID-19, the Merritt Hawkins survey found.

My Own Telemedicine Visit

A few weeks ago my family practitioner called to let me know they have temporarily suspended in office visits. My overall health is good. No chronic conditions but my doctor prefers to have 6 month follow up visits which include routine lab work.

They wanted to know if I would be willing to have a virtual office visit in place of the customary one.

I thought about it for a moment. No need to get dressed, no mask, no hand sanitizer routine. I won’t have to strip and put on a hospital gown. Won’t have to weigh in.

What’s the downside?

Let’s go for it.

The overall visit took about 20 minutes. My doctor was more chatty than normal. Even greeted me with “Hi Bob” like we were old friends.

She had questions for me, primarily about alcohol consumption during COVID-19 “lock in”. Also asked about what I was eating and how was my weight?

Normally I only drink on weekends, having a glass of wine or two with supper. Now I find myself having wine closer to 5 nights per week vs the usual two.

Is that a bad thing?

No, not really. Just don’t let it get away from you was her response. Same with your weight.

Because I had read about doctors losing money on virtual visits I wondered about the bill.

A month later I had my answer.

Normally these visits run around $450 (gross charges) including lab. After Medicare repricing the total comes in around $150 or so.

My televisit was $210 repriced to $86.

Saves me money but how about the medical practice? How long can they survive with 40% less revenue?

I suppose time will tell.

Medicare Supplement Plans, Medicare doctors that take Medicare, medicare telehealth, telemedicine, televisit, virtual medical care

Do All Doctors Take Medicare

Bob Vineyard · February 6, 2020 ·

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?

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.

Do all doctors take Medicare

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.

Can My Doctor Refuse to Treat Medicare Patients

Medicare participation

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

https://www.gamedigaprates.com/

 

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.

#DoAllDoctorsTakeMedicare  #GeorgiaMedicareDoctors  #GAMedigapQuotes

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Don’t Buy Something You Don’t Need

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Current Posts

  • Doctors Take Medicare and are Near Me
  • Concierge Medicine Problems and Medicare
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  • Help! We Have No Money for Medicare! Are FREE Medicare Plans an Option?

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