Doctors Fleeing Medicare So Shop Around Before You Become Eligible

Following up from yesterday‰Ûªs post comes news that doctor‰Ûªs are fleeing Medicare. According to the New York Times, some physicians including internists and many specialists are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage.

Why: reimbursement rates are too low and paperwork too much of a hassle.

Doctors who opt out can charge whatever they want to patients but neither they nor their patients can try to seek reimbursement from Medicare. Doctors who remain in the system fall into two categories, participating and nonparticipating. The latter receive a lower reimbursement from Medicare, and the patient has to pick up more of the bill.


So you the consumer really need to shop around and do so before you become Medicare eligible. Easier said than done because as the population ages, there are fewer people opting for medical careers especially careers in primary care.


Talk to your doctor. Even if not accepting new Medicare patients he/she may allow existing patients to stay. The Times also mentions an option for patients to sign a private contract that stipulates the patient will be responsible for paying the doctor‰Ûªs fees and that lists exactly what those fees are and what they cover. Some doctors may be willing to negotiate and tailor prices to what patients can afford.


www.medicare.gov provides a list of Medicare enrolled doctors. Other sources are state medical societies and local hospitals. But that‰Ûªs no guarantee they will see new patients. A new trend emerging is the use of retail health clinics as primary care providers. Most accept Medicare. Another, more expensive option is concierge medicine. In the most popular kind, doctors accept Medicare and other insurance, but charge patients an annual retainer of $1,600 to $1,800 to get in the door and receive services not covered by Medicare, like annual physicals.

The other form of concierge medicine ‰ÛÓ doctors who have opted out of Medicare ‰ÛÓ is more expensive with fees ranging as high as $15,000 a year and cover office visits, access to the doctor when care is needed, referrals to specialists and thorough annual physicals.


So as we always advise. Become educated on these issues before they affect you or a loved one and start making preparations sooner than later for health care in your advancing years.