When I first arrived in our new town, I set out to find Mom a doctor. I got good referrals. Every office I called said that they were not taking new patients. This week I needed to go to the doc and called one of those offices. Suddenly, they are taking new patients.
Can a doctor legally refuse to take Medicare patients? No one has come out and said this, so I'm not sure now.
I think the denial of Medicare acceptance is discriminatory against an entire segment of the population - the retired/elderly - and there should be some system to ensure coverage is available. Maybe there should be a requirement that doctors or clinics/medical groups, whatever, accept a minimum percent of Medicare patients... If this was spread uniformly across the board, everyone would have to "share the pain"? Non-compliance could carry a penalty at tax time (any incentives or deductions currently available - I don't know? - denied?) Something! I've gotten to the point that if someone does accept Medicare I'm somewhat skeptical why - can't they attract enough "paying" patients and have to take the dregs? This is an issue I'm not seeing debated, or even acknowledged, by the current controversies...
A hospital won't turn away someone if they can't afford treatment [per a law put into place by President Reagan], but a landlord can turn down a person if that person doesn't meet the income requirements to pay for said apartment and/or has terrible credit.
You have to sign up during the fall Open Enrollment period. The premium this year is 0, the basic copay for an office visit is $15, labs are reasonable. Within the system you can always get in to see somebody, but you do need to get to know which doctors work the system best. I had a really good primary care dr, who after 20 years knew about my bad experience with med side effects and knew I preferred not to take prescription meds if possible. When he retired, they put me on with a doctor who is a pill-pusher and when I told him I have already been there, done that with the meds he wanted me on, he called the front office and told them I needed a different doctor and put me down on my record as "non-compliant." My current doctor is willing to let me work with diet and supplements to keep my lab results within reasonable limits, and the other day the nurse for a specialist I was seeing high-fived me when she found out I was on NO prescriptions. She said she hadn't seen anybody over 50 who wasn't on at least three regular meds. There have been times I've had to go through several referrals to find the right doctor for something, but once you get to know their system you can make it work.
There was some talk about Obamacare killing off Medicare Advantage, but so far its still going, and seems to be working for me.
I wouldn't quit Medicare, the program is too good to give up. Just keep dialing around until you find a doctor that has an opening for a Medicare patient. It's my understanding that many doctors will take Medicare but they have a quota for new Medicare patients, and if that quota is met, then they won't take any new patients. You would have to wait for an opening.
Some urgent care facilities have primary doctors that you can use as your regular doctor. I just switched over my parents [mid-90's] to the urgent care physicians mainly due to the fact the office is just down the street, minutes from my parents house, young fellows who are up to date and no nonsense.... no more long drives on the major high speed highways to their prior physician.
I worked for doctors for years in the insurance department so I have heard all of this. At first I thought it could not be true, if they were a participating Medicare doctor then they HAD to take you. I have seen this happen in the past and it is getting worse. Medicare reimbursements actually set the playing field itself as all other insurances look to them and then base their reimbursements off what Medicare is paying. We use to have secondary insurance carriers that paid the remaining 20% in full but now we are coming across those that only pay a portion of what is owed or they are now charging copays. Our insurance system is crazy making, which is why I quit my job. It literally changes every single day and it is so difficult to remain on top of all of it....my brain after 10+ years felt like it was full and could contain no more!
Ask the doctor you want to see if they have dis enrolled from Medicare period or are they only taking a certain number of new patients at different times throughout the year. If it's the latter then you may be able to call back and get in later on.
Do you have the booklet, " Medicare and You"? There is a massive list of participating physicians in every state.
I went to Medicare.gov and under Searching for Doctor/Hospital I typed in Evertt Washington as the location. the names of 18 geriatrics doctors came up. That's whats in the link above. Most of them appeared to be affiliated with the Everett Clinic. I don't know if you're looking for a Geriatrics doc, but you can type in another specialty if you need to. Good Luck!!!
One advantage of living in a large metro area, I never had a problem finding a new doctor for my parents who have been on Medicare for over 25 years. Nor for myself as I am also on Medicare.
There are a lot of myths floating around about Affordable Care Act [ObamaCare]. One myth I wish to break is the rumor about the Federal government cutting funds to Medicare. What is being cut is Medicare fraud, which is a good thing.
The ACA closes the “donut hole” that was causing Seniors not to be able to afford their prescriptions, another good thing.
ACA expands existing coverage for seniors, including preventive care and wellness visits without charging you for the Part B co-insurance or deductible. Seniors will no longer need to put off preventive care and check-ups due to costs. This reform has been active since 2011 and gives seniors better access to cancer screenings, wellness visits, personalized prevention plans, vaccines, flue shots and more.
As others have pointed out, it is the very low reimbursement rates and delayed payments that deter some physicians from accepting Medicare/Medicaid patients at all. Often the reimbursement amount is not even enough to cover the office's expenses of that visit. (staff wages, utilities, insurance, syringes, etc.)
I know of one state in which a physician may NOT allow any patient who is on Medicare to pay cash for the visit....but the physician does not have to accept Medicare patients. So, it's a catch-22 situation where a moderately affluent senior who has the resources to pay the $150 office visit is not permitted to do so. Weird.
Yes doctors who DO NOT PARTICIPATE WITH MEDICARE do not have to see you unless you are willing to pay in cash. IF THEY DO PARTICIPATE WITH MEDICARE, I DO NOT THINK THEY CAN REFUSE TO SEE YOU AS IT WOULD BE A VIOLATION OF THEIR CONTRACT.