Why Would Doctors Refuse To Take Medicare Supplement Plans?
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- Опубликовано: 2 авг 2024
- The big selling point of Medicare Supplement plans - or Medigap plans - is that you can visit any doctor in the country that participates with Medicare. However, many people run into some unique situations where their providers are rejecting their supplement plans. We explain why and how you can fix this in this video.
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⏰ TIME CODES ⏰
0:00 Supplement Denial Problem
0:30 Accepting New Patients
1:18 Healthcare Terminology Issue
3:22 Card Confusion
4:10 Accepted Insurance List
5:30 Smaller Insurance Company
6:16 Large Insurance Company
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#medicare #theretirementnerds #socialsecurity #90daysfromretirement
Federal Disclaimer:
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.
NO doctor has to accept Medicare, but any doctor who accepts Medicare has to accept whatever supplement plan you have. However, billing personnel don't necessarily know what they are doing.
Thank you. That’s a clear explanation. The title of this video is scary.
@@TiredEmpath CLICK BAIT
@@almoemason Pretty much yeah.
@@almoemason Exactly!
Well it got my attention. That could be why he did it. He wants of us seniors to know what to call our insurance. I have seen so many misspoken people about Medicare. Medicare advantage .
Medicare is a huge learning curve. Combine that will misinformed or uninformed medical personnel and it leaves us in a lurch. This video taught me that if my provider accepts Medicare then they must accept my supplement. Valuable information in this world of misinformation. Thank you!
Thank you for watching! 🙂
Yes they must and ALL supplement plans pay the doctor the exact same fee schedule.
This is true. The major healthcare system where I live has dropped their contracts with all United Healthcare plans (employer plans and Medicare advantage). UHC patients are now cash pay only, unless you have a UHC supplement. That is the only UHC insurance they accept, because they have no choice.
I found out last year that the desk clerk at my urgent care center entered my Plan G card as primary. Oops! And didn't understand my frustration when the claim was rejected and I complained. After about an hour of (ahem) discussion, she finally rolled her eyes and switched the cards around on my file. Surprise! The claim went through!
Happens more than we wish it did... Thank you for sharing!
My GOOF Kid did that TOO. Told her 3x still Mucked it up ..
I had a gal at an office mix up my supplement plan with an advantage plan. She kept telling me I had to go through them. Frustrating - had to speak with the office manager.
You are exactly correct. And it is confusing, I think it was designed to be confusing so it becomes easier to prey on senior citizens. We are in our 70s with Medicare original with supplemental plan f. We have no desire to ever change after two heart attacks, cancer, and diabetes. Yes, I have been told no by doctors. But I have excellent care by others. My advice to those considering which to choose is Medicare original and buy the most expensive supplement offered. You will need it as you get older.
It was never this confusing until the Bush administration added the option of Medicare Advantage plans (part C) to 'simplfy' and reduce costs. Both of which never happened, and Advantage plans have many instances of significant Medicare fraud.
Love your content. You were born to explain these things. Thanks for clearing that up. Big sigh of relief from me and others I'm sure!
Thank you so much! ❤️ 🙏
Thank you Erik!!! I am so new to trying to understand all this Medicare my head is just spinning🤪🤪🤪🤪
It's a lot! Appreciate you watching and your comments!
G plan has unaffordable premiums for me , I dropped it and pay the uncovered bits myself. Works very well and I save money.
Off topic but I've got a friend who was seeing a specialist for what he had diagnosed as Crohn's disease. He then turns 65 and they tells him he would need to see a new doctor as the dr doesn't treat medicare patients. So he changes doctors and the new one runs new tests only to find out he didn't have Crohn's but had pancreatic cancer instead. Luckily it was early stage and he had surgery and is doing fine 5 years later. Good thing his old doctor had a no medicare patient policy otherwise he would probably be dead.
Wow! 😵 thank you for sharing!
Thank you for the information. What a mess our healthcare system. I'm going to try and retire overseas.
This is the first time I’ve seen this problem addressed. I’ve watched dozens of channels that talk about Medicare, but none of them have ever talked about this. And he breaks it down into elementary English.
Thank you so much 🙏
Doctors are *not* refusing Medigap/Medicare Supplement plans. As long as the Dr. participates in Medicare, they don't care what your supplemental plan is.
Some Doctors & hospitals ARE refusing Medicare Advantage plans, nationwide. I'd be more concerned about that if I was a retired senior.
We think you'd like what's in the video 🙂
EXACTLY and just a note, unlike medigap, where they have to take all if they participate in medicare. Advantage plans ARE NOT MEDICARE and they are free to pick and choose which ones they want to accept.
@@almoemason Absolutely!
@@almoemason Doctors who participate in Medicare can limit the number of patients on Medicare that they accept according to the American Medical Association (AMA) Medicare Participation Options FAQ for doctors:
Question 4. Since so many physicians in my area have stopped
taking Medicare, am I able to simply limit the number
of new Medicare patients I accept so that I am not
overwhelmed with Medicare patients? It seems better
than refusing all Medicare patients.
Answer: Yes. It’s up to each physician how many new
Medicare patients they accept in their practice.
I think this policy is easily abused since if the doctor does not like your particular supplement insurance provider, they can just tell you that they're not accepting new Medicare patients at this time whether or not they are accepting other new patients.
ALWAYS ask if a Medical Professional takes your Health Insurance. I’ve been doing this since I was 22 years old, when I was forced to search out the best I could find to save my life! It took over three years out of my life, while working full time and living on my own.
Thanks for the information. Very helpful. 👍🏻
Congratulations, beautiful family, too!
Thank you so much!
The doctor office submits the claim directly to Medicare and then Medicare submits it to my Supplement Plan. The doctor doesn’t need to have contact with my supplement plan and doesn’t have to like my Supplement plan. The Supplement Plan is for ME to alleviate any additional costs beyond what Medicare pays and determines what I owe. That has been my understanding when I transitioned from a MA plan to Original Medicare earlier this year. I was told that all I needed to show is the Medicare card and Medicare interacts with the Supplement. Am I missing something here? Btw, my doctors participate in Medicare.
Probably they need it to determine if they need to collect coinsurance amount from you or not. If you have a verifiable plan then they won't ask you for any payment.
@@kenniekennard7684 Thank you. I didn’t show my doctor office my supplement card and it worked out fine. I’m still confused as to why a doctor would care which supplement plan I’m on so I’ll keep reading comments.
@@TiredEmpath Some supplements, like Plan N, require that you pay the doctor a copay. Plan G, on the other hand, doesn't require that. So the doctor needs to know which supplement to know if they should collect a copay from you.
The billing person still needs to know who to tell medicare the secondary insurer is.
You are not missing anything, and are correct. Many don't know that and just show the supplement card as primary insurance (not Medicare) and get rejected. Always show the Medicare card first if you have a supplement 🙂
This is off topic but my own physician (double-boarded, Hopkins-trained) will not accept any Medicare Advantage insured pts. unless they are already established pts. The problem for him are their strenuous efforts to deny pts. appropriate diagnostic procedures and medical/surgical care.
No such thing as Medicare Advantage. If you chose an Advantage plan, you have left medicare for private insurance.
@@almoemason Yes, but that's how it's commonly referred to. And that nomenclature is undoubtedly intended to confuse the potential victim.
@@wholeNwonI don't think people say that to intentionally confuse people, I am pretty sure they just don't know any better. I feel that a responsible persons tries to correct that mistake, as I have done here.
@@almoemason I was referring to the incessant TV ads.
@@almoemason There's a connection though. Medicare has to approve these companies and they are paid by Medicare to cover our Medicare benefits.
My understanding is the doctor's office doesn't work with your supplement plan at all. When Medicare pays your claim, they are the ones that submit the rest to your medigap company.
Correct! The office doesn't need to, which is why if people aren't informing the office that they have Medicare, and just show a supplement plan card, things can get confusing for both parties :)
Well, that title scared the crap out of me. I start Medicare and Social Security in May and have selected United Healthcare Supplement G. My hospitals and doctors accepted United Healthcare when I was treated for cancer so I assume that they and my doctors will accept it with Medicare though I will ask them the next time I see them. I'll also dot the i's and cross the t's as well. I've already paid my last ACA plan check last month and will be paying about half as much for Medicare A, B, Supplement, and D. I'm hoping that things go smoothly. In the meantime, I'm running outside and lifting in the gym as my preventative healthcare program.
If your provider office gives you grief, have them watch this video :)
Your doctors have to accept Medicare. It shouldn’t matter what Supplement plan you chose on your end of things. Medicare submits the claim to the Supplement, the doctors don’t. That’s my understanding and how it’s worked for me. I’m open to being corrected. I don’t think you have anything to worry about.
Clarification: Your doctors have to accept Medicare for you to use your Supplement plan.
Yeah. Stupid title. He gets what he wants cause we’re all commenting on his misleading video.
@@TiredEmpath Doctors DO NOT HAVE to accept medicare. The rest of what you posted is accurate.
I had a little time and went to the Social Security website and looked around at the documents and found out that I now have a Medicare number so I can sign up for the Supplement G plan now. They said it would take 2-3 weeks and I was expecting around April 20 but they got it done a lot sooner. I wouldn't know about it if I hadn't gone in and looked though. So I guess it's a good idea to check out the website and the messages and documents. I guess that they don't mail them out by default or it takes a long time to get them.
Awesome that it came so quickly! Online does typically have the benefit letter sooner than you receiving things in the mail.
Congratulations! Exciting time to move to Medicare!
I work customer care for a carrier that sells advantage and supplement and let me tell you, this **** happens all the time. Especially with outpatient labs, radiology outfits, EMS. No idea why. But ive had to help bewildered senior navigate billing IVRs to talk to a person so we can tell them it's not a gd HMO OR PPO
Anyway I'm on a holy crusade to remind everynew Medicare member that comes across my line not to let these clowns bully them.
Thank you for sharing this! Getting a lot of comments saying this isn't real... it is, in fact, very real.
Medicare is your primary insurance,not your secondary. Your secondary may or may not be accepted by a new doctor. Doctors who accept Medicare accept what Medicare pays them. Your secondary picks up from there,less any co-pay or deductibles your plan may have. Always check with your secondary insurance on any future procedures before having it done so you don’t get slammed with a huge bill. Always do your homework . Sounds like a lot, but it isn’t. Case in point, I had a total shoulder replacement. Submitted bills to Medicare and my secondary totaled near $250k…my out of pocket was under $100.00. I asked lots of questions,kept everything within the network down to my surgeon and am sleeping like a baby today knowing this case is closed.
Perhaps a group of doctors should get together and plan out first the tort law issue that drives up insurance. I would be glad to sign off on a legal document to that states that I would not sue over X amount of dollars so that these doctors could practice with more dignity. In the EU there is a cap on how much you can sue for like 275k. Here in the US, the skies the limit which is a dangerous scenario for greed and nefarious corporations like big pharma, big insurance, blood suck lawyers, etc.. As you can see, no one in leadership can talk about the insurance reasons driving up the health care costs. This is the root cause and the key to lowering costs.
Very helpful
Good birdie I’ve always been told to ask if the physician accepts Medicare. If yes, then there is no need to initially mention the supplement plan.
Correct. If they participate with Medicare, they shouldn't need your supplement plan card. There are some insurance companies that have some coordination challenges, so it doesn't hurt to show the supplement plan card, as long as the physician knows Medicare is primary. Thank you for watching and sharing!
To make sure your Medicare covers your medical practitioner or service, check with a Medicare service rep first. If you need advice, call your Medicare agent. Don't depend on the doctor's billing department for accurate info. They go nuts trying to figure out which company covers who and to what degree.
Never show your supplement card (with Original Medicare only).
Office staff will enter your Medicare number and Medicare will return the supplement info including any co-pays owed.
Other relevant terms that Medicare beneficiaries don't understand are "Participating Providers" those who accept assignment, "Not-Participating Providers" those who do NOT accept Medicare assignment and "Opt-out Providers" those who aren't contracted with Medicare, don't accept Medicare AND Medicare will not pay for ANY services done by them even if it is a Medicare-covered service (no contract with Medicare).
Good analogy
Thank you :)
Good information and really good thumbnail - it got me to click and watch.
Hope it was helpful! Thumbnail represents the words we have heard hundreds of times over the years from clients visiting provider offices. Those who know experience this know it's a real thing 🙂
Appreciate you!
I hope you keep making these videos, you are a wealth of knowledge!
Thank you so much Jackie!
Because so many negative things have been spread about the Advantage plans. It’s all been how great the supplement plans are.
Thank you for your clear explanation.
Very good
Thank you!
I saw my doctor a few weeks ago and we were chatting and he told me he is so busy he has to work Saturdays at times. I wondered out loud why the clinic was still accepting new patients since they are so busy. He then proceeded to tell me they are not accepting new patients.
So, yes, you are correct there is a doctor shortage. And I am very grateful I have a doctor and that I am not on the outside looking in.
Thank you for sharing!!
How many illegals have cross the boarder and now getting free healthcare????? . I get calls every day too join one of the advantages plans.?The person on the phone can’t even say my name right. Wish they would stop calling three times a day.
What do you expect when an additional 11 million Illegal Aliens came in the last 3 years?
Oh yikes. Have to work Saturday? Welcome to the real world.
@@jacqueandrew1033 There are no people that work harder than those in the medical field. I feel sorry for the doctor that is your doctor; a woman with 0 compassion due to the coldness of your heart.
Curious to see what the future brings for supplements. Only 3 now seem popular. Maybe only two to chose from in the future; plan N (excess charges are rare and mostly with psych. doctors) and HDG.
Very likely. A new letter may emerge... we still O - Z to go 🙂
You need to ask before you try to use it and if the Dr. doesn't accept it, find a new doctor.
This video is perfect proof that you should not believe everything you see on the internet.
How so?
@@wholeNwonThe title is wrong ...
Supplements are much better than Medicare Advantage Plans.
Poor analogy. You've done more to confuse here than to clarify anything.
@@wholeNwon The guy is a full out jackass for posting something that is 100% misleading to the elderly population. A true POS!!!
Once I turned 65 and started Medicare my doctor of many years said I must sign up for his Concierge program for $1,200 year or he wouldn't accept my Medicare with BlueShield supplemental. I was in Shock! Needless to say he's no longer my doctor which is sad.
Thank you for sharing this. Seems like a lot of people don't believe this is happening. Sorry you had to experience that.
Note: your doctor was not just refusing you medicare supplement, which is what this video was about, He is refusing ALL insurance.
@@almoemason actually the doctor has accepted my Anthem Blue Cross for 5 years now with no Concierge plan. He will accept Medicare plus supplemental insurance but ONLY if I pay $1200.00 yr for his concierge plan. There was no problem until I turned 65 and switched to Medicare
@@jzschomler8229The situation you are describing is ILLEGAL. Medicare would surely remove his ability to take medicare and I would bet your state medical license bureau would have something to say about it too. If you give me his name and where he practices I would be happy to start the ball rolling on him losing his ability to take medicare and possible his license to practice medicine in your state.
@@jzschomler8229 What you are describing is ILLEGAL. If Medicare was to find out they would surely ban him from taking Medicare. I am also pretty sure that your state insurance board might have a few things to say about that too. If you tell me his name and the state, I would be happy yo get the ball rolling on his legal troubles.
prob need to call the doctor BEFORE buying a plan
Thank you for the Medicare plans, thank you
Thanks for the information.
Thank you for watching!!
You might have missed one more. Primary Care Drs in my area occasionally have closed their new patient admissiona to those on Original (Fee For Service) Medicare, with ot without a medigap plan, and will omly accept HMO (MA PD) new patients. They do this to help out the Medical Groups that drove patients to Medicare Advamtage plans. This does happen.
Very true! Thank you for adding this!
That's great information. I was wondering about this, and couldn't find the answer anywhere.
Terrific info!
If a Dr. Or hospital takes Medicare A & B they are required by law to take F, G & N.
A disadvantage Plan, C plan, etc. replace traditional Medicare and Drs and hospitals are refusing this because it’s not paying like traditional Medicare.
Yes. I have been on both traditional Medicare and MA plans. Original Medicare always reimbursed the doctors more than the MA plans. As of this year (birthday rule), I made it back to Original Medicare with a Supplement. I was afraid to be stuck on Medicare Advantage with so many dropping them left and right.
To make things more confusing, there is a supplement plan C and then advantage is sometimes referred to as "part C". Entirely unrelated. Cool system.
More and more doctors and other health provider are refusing to accept Medicare, Medicaid and even private insurance. They expect payment in full at time of the service.
Then, It is up to the patient to submit their claims to the appropriate insurance .
Hard to blame the doctors considering the high cost of keeping a expensive staff to handle and keep insurance billing straight for thousands of patients. If they do not accept insurance, they can charge and keep the full amount of their services instead of the reduced amount that health care plans are paying.
Very true. It's a complicated system all the way around. Thank you for sharing this!
Definitely expensive. My Doctor says of the 5 people he has on staff, 3 spend their days dealing with insurance.
A couple of things I noticed when my PCP retired two years ago and I needed a new Dr., was that although almost all accept Medicare, and most contract with at least some Advantage plans, many of the private-practice doctors specifically state: "We do not accept Medicaid". And many were not accepting new patients, period.
@@g0989 thank you for sharing this!
Some offices confuse supplements with primary coverage.
100%. Causes problems. Thank you!
You definitely have doctors that are accepting Medicare and the supplemental programs but as an example, I just called to see a neurologist and I’m told that they’re taking appointments into December
Yes. They will try everything in the book to avoid this government joke of healthcare. Basically they are probably hoping that you die or find someone else. This is the end game of declining morals in this country. I always thought what the manifestation of this would look like.
Even though at time stamp 5:17 you clarify this issue, your title is very misleading. I think you did it on purpose -- click bait. It is the only reason I clicked on your video. Just so everyone who may not have watched the video through to this point clearly understands. If your doctor accepts you as a medicare patient, THEY TAKE YOUR SUPPLEMENT PLAN. It is the law.
Exactly!
Doctors who participate in Medicare can limit the number of patients on Medicare that they accept according to the American Medical Association (AMA) Medicare Participation Options FAQ for doctors:
Question 4. Since so many physicians in my area have stopped
taking Medicare, am I able to simply limit the number
of new Medicare patients I accept so that I am not
overwhelmed with Medicare patients? It seems better
than refusing all Medicare patients.
Answer: Yes. It’s up to each physician how many new
Medicare patients they accept in their practice.
I think this policy is easily abused since if the doctor does not like your particular supplement insurance provider, they can just tell you that they're not accepting new Medicare patients at this time whether or not they are accepting other new patients.
@@luminiferous1960 ABSOLUTELY NOT TRUE. You either accept medicare or you don't accept medicare. You can refuse to accept new patients, but you CANNOT accept new patients and not accept new medicare patients. You also cannot be selective on what supplement plan you take. I am curious how did you come up with your statement? Did you just believe some one that was stupid, or are you the one that is stupid?
@@luminiferous1960No they CANNOT.
Most iinformative video=Thank you!!!!!
Thank you for watching!
I am 67 years old and entering my third year of Medicare coverage. I chose a plan G through anthem Blue Cross Blue Shield as my supplement. My doctor informed me after a year that their practice would only take Humana Medicare advantage beginning January 1 of the next year. If I wanted to remain a patient at their practice I would have to drop my plan G and enroll in Humana. I felt the plan G was better for my situation and therefore had to find another doctor.I have been a patient at this practice for many years so it was very disappointing.
Thank you for sharing. This is a great example of what we are talking about.
If you have supplement plan G, it doesn't matter who your insurance company is. If that doctor participates with Medicare, they need to accept your supplement as well.
So they take Humana Medicare advantage and NOT original medicare? That’s interesting.
Is this the Medigap plan G or supplemental Pan G? Is there difference?
@fmac336 great question. Medigap and supplement are the same thing.
Medigap Plan G = Medicare Supplement Plan G
Thank you for acknowledging and addressing this GIANT issue! Trouble is, the person answering the phone may not have a grasp of all this complication. Just in order to MAKE a tele-doc appointment, I had to send the health network images of both sides of both cards- medicare and supplement, I suppose so they could verify coverage. THEN, I was allowed to schedule an 'introductory' televisit scheduled in MAY! That's 5 months into the year when I'm paying these premiums, and still have no identified doctor. I don't know if I made the right decision getting a G supplement, I think I'll give your office a call since California has the birthday rule, and my b-day is in July.
Thank you for sharing your experience. Some think the thumbnail is click bait. It's the words we have heard hundreds of times from clients who've been denied by provider offices. If you've experienced this - like you have - you know this is real.
I have never once had my Anthem supplement plans denied.
Doctors who participate in Medicare can limit the number of patients on Medicare that they accept according to the American Medical Association (AMA) Medicare Participation Options FAQ for doctors:
Question 4. Since so many physicians in my area have stopped
taking Medicare, am I able to simply limit the number
of new Medicare patients I accept so that I am not
overwhelmed with Medicare patients? It seems better
than refusing all Medicare patients.
Answer: Yes. It’s up to each physician how many new
Medicare patients they accept in their practice.
I think this policy is easily abused since if the doctor does not like your particular supplement insurance provider, they can just tell you that they're not accepting new Medicare patients at this time whether or not they are accepting other new patients.
ABSOLUTELY NOT TRUE. You either accept medicare or you don't accept medicare. You can also refuse to accept new patients, but you CANNOT accept new patients and not accept new medicare patients. You also cannot be selective on what supplement plan you take. I am curious how did you come up with your statement? Did you just believe someone that was stupid, or are you the one that is stupid?
My doctor is having trouble getting reasonable reimbursement from Medicare and insurance in general. He is thinking of shrinking the practice, dropping some insurance, and going concierge with patients paying $2K/year with guaranteed access in hours.
Medicare and other insurance companies negotiate what they pay for various services. It's up to doctors if they want to accept a particular insurance or not, but most doctors I have talked with say they make most of their money off Medicare patients, because of volume. Not taking insurance at all is a big gamble, but maybe your doc has already made his money?
Can’t blame your physician for that. Medicare reimbursement rates are very low.
Two thousand for a concierge yearly membership? A good deal. Mine is twice that. For me it is worth it.
Find another doctor.
@@alansach8437 I think he is looking at his net cost. He will see fewer patients and earn slightly less. But, without so many insurance issues he can reduce staff. He says 3 of the 5 people in his office deal with insurance. So, in the long run he may net more.
Thank you so much for these videos, I’ve learned a ton from you! One question, I’ve stopped working but my employer is paying me another year of salary and medical insurance and my plan has HSA. I’m turning 65 in a few months so do I have to enroll in Part A? I know if I do, I would lose HSA so can I wait till my plan ends? Also, I’m planning to get on my husband’s company plan when my plan ends. Will I have a problem since he’s already enrolled in Part A?
Be careful with this. For your employer plan to be creditable it must be from active employment. I don't know if them paying you a salary counts as active or not.
Check with your local Senior Center, Council on Aging, etc to see if they have a volunteer Medicare advisor (NOT an insurance agent) available. Ours was so much help, and understood Medicare, Advantage plans, Part D plans, etc thoroughly.
@@stormyweather2807 You can also call Medicare itself at 1-800-MEDICARE and ask them.
@@stormyweather2807 Also note, if you work for a company with fewer than 20 employees, you can not keep your work health insurance when you turn 65. Either you take medicare and a supplement or an advantage plan. Other wise you don't have health insurance (unless you happen to have VA, Tricare, or ChampVA
This gets more complex based on several factors. HSA timing is important. Happy to answer. Want to send me an email to erik@theretirementnerds.com
There are a couple follow up questions to make sure we have the whole picture. The plan your husband's company offers will play into this.
I am not on Medicare yet. I recently went for a wellness visit and noticed while in a patient room my family doctor had a post on his bulletin board about all the Medicare plans. It stated anyone on a plan had to pay services up front and then they would submit the claim to Medicare. Not exactly sure what that is about or why except maybe he charges more or they are slow in paying his office. On another note I would definitely not call this "The Retirement Nerds" as I feel you have to be pretty smart to have all this knowledge about Medicare. Then to bring on experts for videos in retirement, investing, financial strategies, and social security is pretty smart. Just my opinion.
Interesting sign that was up in your doctor's office.
Would need to look into that further. Medicare doesn't work on a reimbursement model with participating providers - meaning, you shouldn't have to pay up front and then Medicare reimburse you.
Announcement about the channel name change releasing in 30 minutes :)
I have been on Medicare for about 8 yr's. & ran into this once. It was an ENT. The girl at the desk informed me that I would need to pay for the appt. up front. It kind of threw me off & I did so. They ended up reimbursing me about $150.00 later. But "fool me once"... I would not go along w/ this again. I would just leave. I would go to another Dr. who would see me & then bill Medicare & my supplement & then bill me for the difference.
Medicare and Medicaid are complicated to bill and the reimbursements are insufficient to cover the cost of seeing the patient. Many providers have determined they are barely breaking even if they have a large number of patients with Medicaid and Medicare. This leads to many refusing to participate and are accept the patients at all; especially if they are a private practice.
A bit more than 95% of doctors in the US accept regular Medicare. All the major famous health care facilities (MSK, Mayo, Cleveland, etc. etc.) accept regular Medicare.
Question. Do you have to pay for Medicare if you ARE A DISABLED VET AND USE THE V.A. HEALTHCARE
You do not have to.
You have options, and on the VA site, they recommend getting Original Medicare in the event VA funding changes and depending on your level, but you do not have to.
If you know you will always visit VA providers, your VA coverage works.
If you do not get Medicare when you qualify, but decide you want it later, you could face penalties.
I have been rejected by many doctors who told me they don't accept Medicare patients! Nothing whatsoever to do with refusing new patients! So, all of you know-it-alls out there saying it isn't true have no idea what you're talking about!
Many think this was click bait. Thank you for sharing your perspective. Those who have experienced what you have know too well that this is real. We have had hundreds of calls and messages around this over the years.
This is very timely. One provider who takes my Medicare say the don't take plan G
Sorry that is impossible. If they take your "Original Medicare" card they HAVE to take your plan G. This video is somewhat misleading in that the things he is mostly taking about is a problem with uneducated incompetent staff at your medical provider.
Show them this video 😊
Our country (well-off) has the problem that few doctors accept ANY Medicare or Medicaid. They don't have to. My physician, a close friend, and I were camping and I asked why he didn't take Medicare. "I'd just about break even and the hassle is not worth it." Medicaid was worse in terms of bad patients (1/3 never show up), bad health, payments lower than Medicare and endless red tape..
Something that caught my attention. Fully 75% of his entire salarywas already gone - insurance, personnel, rent, utilities, legal, accounting, billing, supplies, etc. And then he pays 38% in taxes and SS, another $12,000 health care, etc He admitted he was lucky but certainly not "rich". Like your common sense videos.
Great Information.👍
Thank you so much!
No, it's not.
Do I need to give them my Medigap card? I thought that by giving them my Medicare card, the balance would automatically go to medigap?
In most cases, yes. We have seen some supplement companies struggle with that coordination, but in general you are correct
They need both
Yes, because if you don't give them the Medigap card they don't know you have it and will bill you for what Medicare doesn't pay.
They want to know if they have to collect the 20% co-pay, the secondary medigap plan will be paying the co-pay, no need to keep them guessing, provide the secondary insurance card.
The problem with Medicare is that there are too many for profit incursions into original Medicare that makes paying for medical care expensive for seniors. Medicare advocacy groups are dealing with some hospital billing departments that refuse to give straight yes or no answers to whether their hospital accepts Medicare pricing. For people with chronic medical conditions this answer can mean the difference between getting affordable care and facing bankruptcy. The shortage of doctors is a planned reason for higher medical costs. Most Americans support Medicare for all but this voter preference is not represented in congress under the control of the wealthy donor class working in the interests of AMA, the medical and pharmaceutical industrial complex, and the insurance companies all who are only concerned with maximising profits and shareholder returns. The medical schools are funded by the Pharmaceutical companies. In a Medicare for all scheme with a single payer system and with medical schools funded by the public we would have cost controls in a non-profit system in which physicians, surgeons, and other medical personnel would be compensated for their services but investors would not profit from the medical afflictions of others. Don’t believe the argument from scarcity. We have billions of unaccountable money going to fund wars in Ukraine and the Middle East that should be spent here on the welfare of Americans. The same pharmaceutical companies who lobby against Medicare for all are the same pharmaceutical companies who supported the US treasury as the single payer for the pharmaceutical Covid-19 vaccines that did not protect most people from the virus and were dangerous for many people especially young men; moreover, the pharmaceutical companies are immune from lawsuits. This is how American capitalism operates: the profits are privatised whereas the loses are socialised.
Medicare pays then submits to your supplement plan, Doctors who take Medicare is all they need to know. Advantage is not Medicare, the commercials try to confuse you, but Advantage is not Medicare.
It is Medicare, it's just not Original Medicare, aka Traditional Medicare or FFS Medicare. There are two systems you can choose from to get your Medicare coverage. If you prefer Original Medicare, cool, but the agency that runs Medicare, CMS, says when you are enrolled in Medicare Advantage you are still enrolled in the Medicare program, just not in Original Medicare. It's not complicated.
ANY Doctor that accepts Medicare, WILL accept ANY Medicare Supplement Plan.
I’ve NEVER heard of ANY Doctor not accepting a Medicare Supplement plan.
Medicare Advantage? Absolutely! The Doctors can drop out of the network anytime.
Thats exactly why you do NOT want to purchase a Medicare Advantage Plan.
If your doctor suddenly drops out and leaves you in a lurch, just find another one.
Can you stop Medicare when you have health insurance under your spouse?
If you already have it, yes, you can stop Part B (not Part A) and any supplement plan, drug plan, or Advantage plan you may have. Make sure your spouse's work plan has at least 20 employees. When you lose company coverage, you can go back on Medicare Part B with no penalties and you can get a supplement/drug plan again or an Advantage plan
Thank you for your response! I heard people says that they penalized you when time you get back on Medicare when your spouse can’t cover you anymore @ 10% for life. Is that true? I need to confirm this. Thanks!
So the title is "borderline" clickbait. I've been on it less than a year and at first I thought this was something new that the people I worked with on choosing a plan totally overlooked. But my original understanding is correct, despite what the title IMPLIES. No doctor "Refuse(s) to Take Medicare Supplement Plans". If they take original Medicare (and they're seeing new patients, which is a separate issue that has NOTHING to do with the purported title of the video), they have to take whatever Medicare supplement (i.e. Medigap) plan you have. If they're not taking new Medicare patients, it has nothing to do with the supplement plan. In thate case, you won't even get to the point where you tell them what supplement plan you have!
I am a doctor and I stopped taking insurances. Why ? Because your insurance is a contract that YOU signed with your insurance company, I had zero involvement in what you signed and paid for.
When I was practicing in an under-served area, my fee was cut 51% by Medicare before the patient ever walked in. I became a doctor so I could help patients, not becoming a billing specialist, a lawyer, etc. After I had Blue Cross and Blue Shield come in and do a brief audit to make sure I was doing everything correctly and legally, I found out that even though I had diagnosis codes for what I was treating, they said they considered certain procedures to be all rolled into one. Let me say this again, I had different parts of the body and had separate diagnosis codes for those areas and they didn't care, it was all the same to them. In my opinion, the insurance I hated the most of all was Medicare. There is a reason that more and more of us are not taking Medicare and other insurances.
Were your billing problems with Original Medicare, Medicare Advantage, or both?
@@barreloffun10 I think he said "insurances" which mean he does not take any insurance of any kind.
@@almoemason But he did at one time, and I am curious if he found one sort or another less onerous to work with.
@@barreloffun10 the worst one, and the one that scared me the most was Medicare. Like I said originally, I had BC&BS come in and do a very light audit after I had been open for a year or two. I was trying to make sure I doing every correctly and legally. What a HUGE wake up call it was when she came in and started telling me that they considered my separate services on different areas as more or less a 'bundle deal'. I started to get pissed and I told her I would not renew my contract at the end of the year.
I remember going through school and being taught that if you were audited by Medicare and they found problems, it was $1,000 PER incident and/or 1 year in jail. If someone was trying to commit fraud I have no problem with punishing them but as doctor why would I want to even take that chance ? I charged patients my price and I would bill their insurance for them but I was not going to play that insurance game any longer.
@@Sondan1988 BC&BS is Blue Cross/Blue Shield right? If so isn't this Medicare Advantage, not Traditional Medicare.
Have Medicare and G high deductible . Had it 18 months. Never used it. How would i found out if it would cover a CDL Physical... Been paying cash. Dont currently drive . But wish to keep it current . When i had employer provided insurance the wife and adopted kids and step kids had medical issues that having insurance saved the day. I inherited good health . Hardly ever needed it . CDL Physical costs have gone yp and up. Kind of retired now but again would like to keep CDL nust in case. So question is cheaper to pay cash or will Medicare cover it.? 66 years old . Still healthy. Drove a 100 ton copper ore dump truck. Otherwise CDL not really needed.
What is CDL?
@@mellocello187 CDL, Commercial Drivers License. And like Medicare it also has gaps (Endorsements), Passenger, HazMat, Double/Triple, Tanker
You can find a complete list on medicare dot gov. But they do not cover a CDL exam or any other exam required for work. The also do not cover your annual physical.
Great video as usual. I just started Medicare (with my supplement) April 1. Now, however, I'm having buyer's remorse -- I'd like to switch from MoO as my supplement provider to Erik's Insurance. Can you help me do that?😉
Haha! I have a lot of paperwork to do, and a truckload of money to raise fast to make that happen 🙂
I have medicare plan F. Why do you not mention those of us grandfather with F.
This video is clickbait. The title is “My doctor denied my supplement plan G!” . “My doctor” means you have been accepted as the doctor’s “classic Medicare-enrolled”patient, and there is no way he can then refuse to accept Plan G. End of story. The clickbait part is claiming that “my Medicare approved doctor” could ever deny Plan G coverage. He/she can’t… ever.
Sorry you feel that way. We disagree, and that's ok. Everyone can have opinions. Sounds like you didn't watch the video, which is kind of like seeing the cover for the Titanic movie and then saying, "Hey, this cover is clickbait. The Titanic sank... and Leonardo Dicaprio wasn't even alive in 1912!"
Maybe consider a couple things:
1. We have received hundreds of phone calls over the years of people saying those exact words "My doctor denied my supplement plan G." As a group that helps people with this, you may disagree, but this is our real experience.
2. Many people do not disassociate their doctor from their doctor's office, so they phrase it like that. Again, given we help people with this all day every day, we don't correct them and say, "actually, your provider billing department and staff..." we understand them and correcting semantics to make them feel wrong isn't our job.
3. As the video states, if someone is new to Medicare and they visit a doctor they have had in the past, but that doctor does not participate with Medicare, albeit they did participate with whatever arrangement the patient had previously, the doctor (or office 😉) can refuse to accept Medicare and thus the supplement.
4. A doctor can participate with Medicare and then later in his/her career, decide not to.
5. If the patient - new to Medicare - does not tell the provider office they have Medicare, and just say they have XYZ insurance company - their supplement plan company (happens all the time), the provider office just hears the supplement company name, not knowing the patient also has Medicare, it is reasonable for the provider to say, "we don't work with that company' and happens all the time.
Sort of a quick synopsis, more details in the video. Hope that helps!
It also is about the money. We have too many doctors that have borrowed too much money while in school and they want to retire at 55.
Im almost positive Medicare and a supplement dont cover CDL exams. Ask the physicians office though. Since you havent used it even if its covered you have to pay an annual deductible.
I am not trying to be snarky or anything, but what is CDL? I'm guessing it is not Commercial Drivers License, but as with other acronyms, they can have really different meanings (for me, EDP = Electronic Data Processing; years ago, my brothers telling me about an incident during their job and they said EDP during the story, and I didn't know it, as they were NY City police officers and for them, it meant Emotionally Disturbed Person).
@@bikeny It is a Commercial Drivers License and they required to get one every two years
I can't follow what you saying, your speaking very fast
Thank you for the feedback. We will try to speak slower in future videos. There is a setting in RUclips where you can slow it down as well
Come on now
This is unnecessarily confusing and misleading. I’ve been selling Medicare plans since 1986 and other than the 1992 changes to standardization, and the first few years of Medicare Advantage. But this video was only made to induce fear and add subscriptions. Everything he talks about happens to so infrequent this video really is a waste of time.
Sorry you feel this way. We have received hundreds of calls on this. There are many comments in the video of people who have experienced this from Medicare beneficiaries to provider billing offices and insurance carriers.
Shut up.
I want coke! Not pepsi! Yikes...not clear.
This is weird. All the Supplement does is pay the 20% that Medicare doesn't pay. If they accept Medicare there is no reason for them not to accept the other 20%! It's all at the Medicare negotiated price. All Supplements of the same letter are identical regardless of company! Not even sure if they agree to accept Medicare that they are allowed to not accept payment from the Supplement. I would file a complaint with Medicare.
Yes, I’m confused by this video.
If they take Medicare the HAVE TO take the supplement
@@almoemasonYes, this is what I would think. Not doing so after having accepted Medicare would just deny themselves of the additional 20%. As someone else pointed out, they can refuse to take Medicare (very few do, because let's face it, old people are most of your patient poll!), but once you have made the decision to accept Medicare you have to accept the Supplement. Advantage is a different story.
@@alansach8437 YEP you are correct.
This video is superfluous . It sounds informative , but really just says that there may be some confusion , which can be said of any medical transaction involving insurance .
Nothing new or helpful here .
Sorry you feel this way. Some people know this. Some don't. The hundreds of phone calls we've received on this prompted the video. Lots of comments from folks who experience this. We can't please everyone, and we're okay with that.
Unfortunately, because of trial and error, this video taught me NOTHING!
Misleading presentation complicating discussion.
Sorry...but you take a somewhat confusing topic and blow it up with twisting subject matter scenarios. You should take this video down.
Depopulation.
Click bate
So glad that people don’t want to give up their private insurance, so we don’t have a national plan. 🙄
Presumably that's sarcasm.
With the ACA, it is socialized healthcare with HHS suggesting your treatment under the new Complete Lives System guidelines. After reading it, it reminded my the Twilight Zone episode, "Obsolete."
For real. We would pay so much less but no, we have this schizophrenic mess that I have to constantly untangle for people who don't know how to open a pdf
@@Cleverconveyence Yup, all of the rest of the industrialized world is wrong and we're right. And I remember my NY neighbor who needed a coronary stent of a type that was't available in the USA. She had to go to England for it. Then she needed a medication that also wasn't yet available in the USA. So, back to England. Subsequently had her prescription for it filled in Canada!!
So anyone know we’re all the doctors have gone since Joe became a dementia president. Obama’s third term🙏🙏🙏🇺🇸🇺🇸🇺🇸🇺🇸
What's a dementia president? You feeling ok?
Respectfully I have to say look at facts not unfounded information. Then we all make better choices when we are sure they are based on reality and not just untruths or someone's opinion. In this world of information we must be more vidulen that ever to be sure what is real and truthful. If we don't sooner or later it will catch up to us and the Bible warns us for these things. For the Lord loves truth and peace. He warns us to not be afraid when in the presence of fear mongers. That by their behavior you will know them. JESUS has warned us of these things. Love and kindness to you.
No one can fix the healthcare crisis in this country. The politicians on both sides of the aisle are in bed with the insurance companies, the pharma industries, and the entire medical establishment. Can't blame Joe, Trump, or Obama, blame the corporate capitalists who hold us all hostage to their greed.
is it normal to have to call the billing dept and tell them I have already overpaid my deductible amount and still keep getting billed for something called PPD. They say "Medicare didn't cover this so plan g doesn't either. !!!
Yeah, a bit tricky there. The billing department is correct in that if Medicare did not cover something, your supplement plan will not cover that either. I wonder what that procedure or service was that wasn't covered.
This is all about money- nothing else.
What in the world are you talking about? Your analogies are very confusing. 🫤