Are you worried about finding a doctor who accepts Medicare? Good news! According to a Kaiser Survey in 2015, most primary care doctors still participate in the Medicare program and are accepting new Medicare patients. So, it’s quite likely your current doctor will continue to accept you as a patient when you start on Medicare. But if not, here’s how to go about finding a doctor who accepts Medicare, with no surprise costs.
In terms of your Medicare plan, there are three tiers that doctors will fall under: participating, nonparticipating, and opting out.
Accepting and participating in Medicare means the doctor will be charging Medicare 80% of the costs while you, the beneficiary, will only be responsible for the other 20%.
Nonparticipating doctors have the option to accept or decline Medicare assignments. If they decline the assignment then the beneficiary may be left to pay up to 15% more, depending on the state. This is due to the doctor not accepting Medicare’s approved amount.
Opting out of Medicare is another option doctors have. This means you are left with the responsibility of paying the entire cost of services should you go to them.
Since the cost of treatment can widely vary and is heavily dependent on the doctor you choose, it becomes important for Medicare beneficiaries to find a doctor who accepts Medicare. Medicare.gov offers a Physician Compare tool that allows you to search for participating doctors in your area. You will be able to search for a doctor based on specifications you list such as location, name, specialty, group, body part, or condition. However, this list is specific for Medicare and does not encompass Medicaid. If you would like to find a provider accepting Medicaid, you should contact your state for a list since provider networks will vary.
Using these resources can help you understand the medical costs you’ll need to prepare for, and avoid the ones you can. But if you should find yourself struggling to make sense of it all, consulting an independent agent who specializes in Medicare can be very helpful. They can help you weigh all the options, answer your questions, and even do the hard research for you. It’s free, and there’s no obligation. Protect yourself from confusing networks and payment mistakes and contact us today.