Has anyone else exp dr's refusing medicare is there any recourse?

Question

my mom has this problem we live in vt

Answer 1

Good question, you get a star for it!

The best way around this situation is to have your Mom get into a Medicare HMO. Yes, sometimes it does take a bit of a while to get into see a Dr., however, they have their Network and everybody in the Network is paid by Medicare. I had my Aunt and Uncle in one and it worked wonderfully for them.

Now is the time of the year to get the changes made, also.

Before I would do the change though, I would contact Medicare to see how many physicians in your area are in an HMO. This will give you a better feel for whether or not it would be the best thing to do. And, I would do the contact, if possible, over the phone and they will send you out information and you can review it before making any decision.

The reason I would do it this way is because you live in VT. You don't know how close your MD's would be to where you live and this information from Medicare would give you a good indication for distances The phone number to call is
1-800-Medicare.

Answer 2

No recourse a doctor can refuse to accept medicare patients and medicare payments. Mine accepted me because i had seen him when my regular doctor was gone but he accepted no other medicare insured patients. the problem for doctors is the federal government claims it saves money but they do it by under paying doctor's On Jan 1 the medicare payment to doctors will be cut 10%, they have been doing this while paying the insurance companies extra for the expences in running a medicare advantage plan. I don't blame a doctor for not losing money with medicare insured patients. They only get paid 30% of most bills anyway. Now cut that 10%. We pay $96.40 a month for our medicare insurance next year. double what it was in 2000

Answer 3

Doctors have the option of refusing to see Medicare patients. Many of the patients who come to the clinic where I work have enrolled in a Medicare-funded HMO, such as Humana Medicare, Aetna Medicare or Physicians' Health Choice (which has a Medicare/Medicaid plan as well). Not all doctors are in-network with all these plans, but most doctors participate. We have contracts with the PHC and Humana, but not the Aetna.

Here are some websites if you think this is an option for your mom. This isn't a sales pitch, just information.

http://www.physicianshealthchoice.com/?gclid=CLmsxr755I8CFR6oIgodMSBRaQ
http://www.health-insurance-carriers.com/senior-aetna.html?source=google&grp=aetnasenior
http://www.health-insurance-carriers.com/senior-aetna.html?source=google&grp=aetnasenior

Answer 4

Recently when I changed doctors I had a heckuva time finding a doctor who would accept new Medicare patients! For some reason I thought they HAD to...evidently not. I finally found one.

However, with Part D prescription plans most pharmacies accept the Medicare plans.

You can go on Medicare.com to get more info.

Answer 5

The reason doctor's are refusing medicare patients is they pay so little on a claim. I do not know about state laws there but a little research on the net should tell you if they can. If they can I don't know what to suggest other than calling and asking until you find one in your area.

Answer 6

Two recourses -- Pick up the tab or find another doctor (don't hold it against the doctor -- medicare pays less for a lot of treatments/procedures) fortunately, my family doc does accept medicare.

Answer 7

It's a healthcare provider's choice. They cannot be forced to accept any insurance. You just have to find another doctor. The fact is medicare/medicade doesn't reimburse enough. Also, you have to jump through a lot of hoops to get the money. Then they'll not reimburse you for 3-4 months.

Answer 8

We live 55 miles from the nearest hospital,or big town.So far we have not had much problem but have been told that a couple of doctors are not taking any more new patients.Our drug store has stoped taking several providers insurance including mine. I'm having trouble getting oxygen now and may have to pay for it myself after the 1st. of the year.I hope something improves soon for all of us.

Answer 9

It seems some of them have a limit on how many patients on medicare they will take at one time. Went through this before with clients and they were told they couldnt be taken on until someone left or passed on. Sad.

Answer 10

Not yet but I'm sure I may be refused at some point in my life. I guess some doctors refuse to accept Medciare because it takes so long to recoup their money. There's no recourse, she'll have to shop around I guess. Good luck to your mom. :)