Shocking Truth: Can Doctors Refuse Medicare?

Shocking Truth: Can Doctors Refuse Medicare? Call us at iHealthBrokers today at 888-410-0344. Our services are 100% Free!
Are you approaching retirement age and wondering if doctors can refuse Medicare? Find out the shocking truth about Medicare denial in this video. We'll cover retirement fears, Medicare premiums, Medigap, and Medicare Advantage
★☆★ABOUT THIS VIDEO★☆★
0:00 Intro
0:20 Medicare Parts
0:41 Original Medicare
2:58 Medigap
7:59 Part D
8:20 Medicare Advantage
9:51 Final Thoughts
Can your doctor actually deny your Medicare coverage? Yes and no, let’s tak about it.
Although it is very unlikely that your doctor would deny Original Medicare, there are several parts to Medicare and that’s where things can get confusing.
Part A
Part B
Part C
Part D
Medigap
Part A and Part B comprise Original Medicare. Truthfully it is highly unlikely that a doctor or hospital would deny your Original Medicare coverage. Original Medicare doesn’t have a network because it is not offered by private carriers. It’s estimated that somewhere around 97% of doctors accept Original Medicare.
So maybe it’s not that your doctor doesn’t accept Original Medicare. Maybe it’s that the specific service isn’t covered.
Now what about Medigap? Medigap is also known as Medicare Supplement Plans. They full in the financial gaps of Original Medicare but do not offer additional benefits. These are offered by private carriers. So, does that mean your doctor might not accept your plan if they aren’t in network for the carrier?
Actually, no!
If your doctor accepts Original Medicare, they accept your Medicare Supplement Plan regardless of who your carrier is.
So, you can pretty much shop your plan based solely on price. Because plan benefits also remain the same regardless of who your carrier is.
But a warning!
Prices do tend to increase on a yearly basis so you want to go with a carrier with a history of low, stable increases as opposed to erratic or dramatic increases. Because remember, after your initial 6 month window, you may be subject to medical underwriting for a Medigap plan which means you could be charged more or denied. So, it’s not usually very easy to switch plans on a yearly basis. A broker can help you with these histories.
I’m going to jump past Part D because these are really prescription drug plans. So your doctor isn’t really going to accept them or not accept them because they don’t have much to do with doctors. That being said, make sure that your prescriptions are included on your Part D formulary to ensure you have coverage.
And now onto the main the event: Medicare Advantage aka Medicare Part C. These are managed care plans that are offered by private carriers. They are a replacement for or alternative to Original Medicare. And this is where things can get a little dicey!
Unlike Medigap plans, your carrier with Medicare Advantage plans matters! And many doctors do not like to contract with Medicare Advantage Plans.
If you are still going to go the Medicare Advantage route, you may want to go with a PPO to provide more flexibility.
If you have any further questions, please feel free to contact us here at iHealthBrokers at 888-410-0344 or ihealthbrokers.com/
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[@njlifeandhealth]

Thanks for your insight! We find 9/10 times when something is denied on Original Medicare it's a coding issue.

[@iHealthBrokers]

That is a really good point! Did you know the statistics for how common medical billing errors are? It is staggering!

[@njlifeandhealth]

@@iHealthBrokers hate to be cynical but I think a lot of our clients get “accidental” bills from providers in the hopes they’ll just pay them

[@iHealthBrokers]

@@njlifeandhealth You may be right but it's pretty sad and quite horrifying to think about!

[@wdeemarwdeemar8739]

I have been a UM RN for over 16 years if a patient needs something I will move earth to get it. Many docs just don’t document well or are lazy or a specialist is trying to up code for money beyond what the patient needs. I am all for the docs making money but some take fee for service a little too liberally.

[@iHealthBrokers]

You are what absolutely what all patients need! Thank you for doing what you do!

[@glennthorstensen5119]

I will be turning 65 in year so I am trying to get as much information as I can. I am leaning towards a Supplement plan and I have heard that these plans are like in a book of business, when they get to expensive, the company closes the book and opens a new book to be more competitive in price. How will I know when my book is closed? How often do you look for a better price? You may have a video on this I could watch?

[@iHealthBrokers]

Great question! So, for example: Aetna has several "companies" in it like Aetna Senior and Accendo. We, as brokers, shop them on a routine basis to make sure you are in the best deal. But as an individual, there is no real need to know (or easy way to know) when they close a book of business. What matters is that you are in contact with your broker and reviewing your rates annually to make sure you always have the best price. Thanks for your question!

[@JohnJohn-wr1jo]

Glen what typically drives these closings is age driven costs. Health care costs for us Boomers will rise exponentially in the next 10 to 20 years for too many reasons to list in this forum. Keep in mind with most services/plans you get what you pay for. Keep researching your options stay away from the Advantage plans at all costs.

[@iHealthBrokers]

@@JohnJohn-wr1jo Thanks for your feedback! And we tend to agree that Medicare Supplement Plans are often superior to Medicare Advantage.

[@Jaykp123aol]

I’m so impressed ❤

[@iHealthBrokers]

Thanks!