Have you recently turned 65 and looking at your Medicare options? Did you get your Welcome to Medicare package? Have you scheduled your “free” Welcome to Medicare preventive exam?
Here are some things you need to know.
- If you currently have a doctor, make sure they accept new Medicare patients
- If you don’t have a doctor, you may have to make a lot of calls to find one that accepts new Medicare patients
- Medicare Advantage plans can be challenging
- Paying for your “free” exam
- Will your doctor take your Medicare supplement plan
- Which Medigap plan is best?
Table of Contents
Finding a Medicare Doctor
Before Medicare you probably never had a problem seeing a doctor, even if you are a new patient. You might have to wait a few weeks for a non-emergency situation, but almost never a month or more.
Welcome to Medicare where the rules are different.
Some doctors are not taking new Medicare patients, even if you have used them for years. Others will either say they are not taking new patients or will put you on a waiting list and call you back in a few months when they have an opening.
What is the problem? Doesn’t everyone want Medicare patients?
In a word, no.
You might find this comment from a MOM (medical office manager).
“Docs may limit how many Medicare patients they see or, like we did at my previous office, not give Medicare patients time slots preferred by commercial or cash paying patients.”
The problem is the low reimbursement from Medicare relative to “commercial” (private) health insurance and the uncertainty on how much they will be paid going forward.
Medicare Advantage Plans – Great Until You Need them
The good thing about Advantage plans is the low premium, in some cases $0. But the old adage is true, you get what you pay for.
Most Medicare Advantage plans have networks which are much smaller than the PPO networks you may have had with a major medical plan. Most major medical PPO networks include over 95% of doctors and hospitals in Georgia.
Advantage networks typically have fewer than 20% of doctors participating and many areas have no doctors or hospitals.
Your current doctor may take Medicare but does not take any Medicare Advantage plans or may just refuse to participate in the Advantage plan you picked.
Welcome to Medicare Advantage . . .
Your Free Welcome to Medicare Exam May Not Be Free
What’s not to love about something free, even if you have to see a doctor to get it?
The “all you can eat” preventive exam covers 118 situations but some of yours may not be free. The one that causes the most consternation is a “free” colonoscopy.
When a procedure is preventive, it MAY be free (only if you qualify under Medicare rules). But once a condition, such as polyps, are discovered the test or exam becomes diagnostic and YOU pay.
Welcome to Medicare is not always free.
Will Your Doctor Accept Your Medicare Supplement Plan?
Unlike Medicare Advantage plans, a Medigap or supplement plan keeps you in the original Medicare system. Any doctor, lab or hospital that accepts Medicare assignment will also accept your Medigap plan . . . even if it is from a carrier you (or the doctor) have never heard of.
All Medicare supplement plans with the same letter (Medigap plan F for example) offer IDENTICAL COVERAGE. The only difference is the premium you pay.
When you pay more you don’t get more, you simply paid too much.
It pays to shop and compare Medicare supplement plans, rates and costs before you buy.
The best Medigap plan is the one that meets YOUR needs and budget. Bob Vineyard at Georgia Medicare Plans has been helping people find the right plan since 1975 and he can help you.
Are you ready to review plans and rates? Get a Medigap quote now.
Who knew turning 65 and Welcome to Medicare had so many challenges?
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