If you are a Medicare recipient, finding a good primary care doctor can be challenging. Many doctors accept Medicare, but not all of them provide great service. How do you know which doctors to choose? Well, we have researched for you! In this blog post, we will list several primary care doctors near you who accept Medicare and provide quality service. We hope this information helps make your search easier!
Whether you have just Original Medicare or Advantage product. You will want to have access to healthcare providers in your area that accepts your insurance coverage. This way you can make sure if you ever need care, it is never too far away.
Finding a Doctor who accepts Medicare Assignment.
There are three different types or levels of Medicare participation that Drs. can be designated
When a doctor accepts Medicare Assignment. This means the Doctor accepts Medicare Patients .Which means they agree to the terms and conditions of medicare payment.
If the doctor does not accept assignment. This means a Doctor accepts Medicare Patients however they do not accept medicare’s payment terms on goods and services.
By doing this the provider reserves the right to charge up to 15% more than the Medicare-approved amount. This can also be known as an excess charge. ( Excess Charges would be covered if the client had a Medigap Plan G).
Non-participating-Doctors are not accepting patients who are on Medicare and bill what they want
So how can you make sure the provider you visit will accept your Medicare insurance as payment?
If you are enrolled in Original Medicare (Part A and Part B), you can use the Physician Compare tool from Medicare.gov, the official Medicare website.
For Medicare Advantage or Medicare Part D plans, you can contact us directly for assistance with this. So you can get a list of participating providers in your area.
Medicare Supplement Insurance plans are accepted anywhere that Original Medicare is accepted.
Does my Doctor Accept my Medicare Advantage Plan?
If you have a Medicare Advantage Plan, your plan will provide you with a list of doctors in their network. Make sure to contact your plan to get an updated list as these can change from year to year. Most of the carriers offering medicare advantage products. Have something called a physician finder tool on their website. With this you can look for Doctors that identify as primary care doctors.
The majority of the HMO plans out there will ask you to assign a primary doctor. This will be the person that manages your care throughout the plan.
If you decide mid-year that you would like to change your primary care doctor. It would be a could practice to make sure that the doctor you are considering is in the network.
Some plans do not require a Primary Care Doctor.
Medicare PPO Plan – you can go to any doctor that accepts Medicare.
Additionally, if you have a PFFS plan. You will be able to use any provider that is willing to accept the terms and conditions of your plan.
If you are on a Part C Plan you need to know that some plans will require referrals.
Knowing which type of plan you have is crucial in understanding how your particular plan works. If you are unsure, please don’t hesitate to give one of our licensed agents a call. They will be more than happy to help explain it to you.
You can also find this information by reading your Summary of Benefits or by logging into your account on the carrier’s website.
When you visit a doctor that is not in your network, you may have to pay the full bill yourself.
If you see a provider that isn’t in your network without a referral (if your plan requires one), you may have to pay the entire bill yourself.
There are a few things you can do to make sure you’re getting the most out of your Medicare Advantage Plan:
- Read your Summary of Benefits so you know what is and isn’t covered under your plan
- Keep an up-to-date list of doctors in your network
- If you have a PPO or HMO plan, make sure to choose a primary care doctor
- If you have a PFFS plan, make sure your providers are willing to accept the terms and conditions. Also know that some may require referrals to see specialists.
When it comes down to being in the best plan to keep your current doctor is where we can help. We have a software that looks up all your doctors and shows what networks they all work within. Making these decisions are tough, so please reach out for a quote! www.myunitedinsurance.com