As people get older, they often need more medical care than they did in their youth. Many turn to insurance programs, like Medicare, to pay their medical expenses. But what can you do if your doctor doesn’t accept Medicare?
Here are some tips for people who want to see a doctor who isn’t accepting Medicare.
What Is Medicare?
Medicare is a federal government health insurance program that provides benefits to American citizens age 65 and older. The program was signed into law on July 30, 1965. Soon after, 19 million Americans enrolled. Today, more than 50 million Americans receive Medicare benefits.
What Does Medicare Cover?
Medicare covers a variety of health care services. Through Part A of the program, people receive hospital insurance. Through Part B, they get their medical insurance. Together, these two parts comprise Original Medicare. You can also purchase additional coverage that pays for prescription drugs, and some beneficiaries choose to get their insurance from a private insurer through Medicare Advantage (Part C).
What If Your Doctor Doesn’t Accept Medicare?
Doctors are allowed to decline Medicare transactions. The federal program’s low reimbursement rates make many doctors unwilling to work with its patients. Medicare typically only pays doctors 80% of what private health insurance plans pay, leading many to think it isn’t worth the lost income.
Doctors have the right to choose what health insurance they accept. If you need to get health care from a provider that isn’t covered, just pay the difference out of pocket. This is possible when the provider is non-participating. If this is the case, you can get Medicare reimbursement to pay your bills.
If that doesn’t work, you can request a discount. Some health providers will be gracious and offer you help with the cost of services. If you still need care and can’t afford services, try going to an urgent care center or asking for a referral from your doctor. These options could cost less and allow you to receive the care you need.
Contact an Insurance Specialist
If you need to see a doctor but don’t have insurance that covers it, you may need to switch insurance plans. Medicare Advantage is an option that allows plan members to see providers outside of the traditional Medicare network. To get started with Medicare Advantage, give Magellan Healthcare a call.
