Retiree's - Grand Junction? (Denver, Broomfield: mortgage, property taxes, tornadoes)

[Bideshi]

Originally Posted by sterlinggirl

You can refuse to sign up for the section 8 vouchers.

Do you imagine that section 8 tenants are the only problem?

Originally Posted by sterlinggirl

How is this different than forcing you to accept vouchers for undesirable tenants?

Simply that Medicare, which I have earned, is what I need to use and doctors won't accept it because they are not making as much money on me as on non-Medicare patients. On the other hand, deadbeat renters who trash my property when I finally get them evicted after six months of non-payment are forced upon me by various legislations. I see the difference clearly. I live it.

[sterlinggirl]

Perhaps a little education would help you to understand what you are asking for...

In order to accept medicare, there is a huge price to pay in regulatory compliance, risking auditing 'raids' that make IRS audits seem tame, overhead incurred to hire paper pushers, compliance officers, continuing education, legal expenses, mandatory computerized billing systems, etc. In addition, Medicare forces its providers to provide free services and will deny payments for something as simple as typing a date instead of writing it by hand.

If they audit you, they'll take a random sample of your files to look for errors. If they find that you made mistakes on 10% of those files, they'll extrapolate that to all of the payments they've given you for that year, and it isn't uncommon for them to demand a million dollar refund of 'overpayments' half a decade after the fact.

Some doctors are making the choice to practice medicine instead of beauracracy, and you want to force them to work under these conditions because you feel 'entitled' to their services.

While you whine that the government interferes in your business......

[CosmicWizard]

I'm not a big fan of the AMA and doctors in general, nonetheless I'm glad to see some of them taking a stand against beauracracy and recovering a degree of independence. As independent practitioners, they are more likely to provide the care that a patient truly needs rather than the care ( or lack thereof ) dictated by the insurance companies.

[multitrak]

Originally Posted by sterlinggirl

Perhaps a little education would help you to understand what you are asking for...

In order to accept medicare, there is a huge price to pay in regulatory compliance, risking auditing 'raids' that make IRS audits seem tame, overhead incurred to hire paper pushers, compliance officers, continuing education, legal expenses, mandatory computerized billing systems, etc. In addition, Medicare forces its providers to provide free services and will deny payments for something as simple as typing a date instead of writing it by hand.

If they audit you, they'll take a random sample of your files to look for errors. If they find that you made mistakes on 10% of those files, they'll extrapolate that to all of the payments they've given you for that year, and it isn't uncommon for them to demand a million dollar refund of 'overpayments' half a decade after the fact.

Some doctors are making the choice to practice medicine instead of beauracracy, and you want to force them to work under these conditions because you feel 'entitled' to their services.

While you whine that the government interferes in your business......

Two of the most troubling reasons are stepped-up threats of prosecution of doctors and growing government red tape, according to the Association of American Physicians and Surgeons (AAPS). In July 1999, AAPS released the results of a survey that revealed, “Medicare regulations and a recent increased government crack down on so-called ‘fraudulent’ billings are actually responsible for severely restricting patients’ access to medical care.”

“This study is concrete documentation of the atmosphere of fear in which doctor practice today,” said Jane M. Orient, M.D., executive director of the AAPS. “Money is not the issue--it’s the government in the examining room. More doctors would rather treat uninsured patients, possibly for free, than risk being prosecuted as a ‘Medicare cheat.’” (bold by mt)

Why Doctors Are Leaving Medicare - by Maury M. Breecher, Ph.D., M.P.H. - The Heartland Institute

[Bideshi]

Originally Posted by sterlinggirl

because you feel 'entitled' to their services.

.....

I have paid into Medicare out of every paycheck since 1966. My tax bill totaled $1600 for Medicare in 2007 and my employer had to match that. Yes, I feel "entitled" to a return on what I have been required to pay in. And how can a doctor take the Hippocratic oath and then refuse to treat those in need? Is it actually the hypocritic oath?

[livecontent]

Originally Posted by Bideshi

I have paid into Medicare out of every paycheck since 1966. My tax bill totaled $1600 for Medicare in 2007 and my employer had to match that. Yes, I feel "entitled" to a return on what I have been required to pay in. And how can a doctor take the Hippocratic oath and then refuse to treat those in need? Is it actually the hypocritic oath?

This is much more complicated than you understand. Yes, doctors refuse all medicare patients because they are not happy with the reimbursements rates. Some doctor's do refuse patients, on and off, to maintain a balance for revenue so that they can maintain financial stability--so they have a mix of original medicare and other insured patients. Doctor's also refuse new medicare patients because their patient load and mix is at a point where additional medicare patients will require resources that strain all patient services. That is because most medicare patients require more care and constant care because they are old and/or disabled.

In addition there are many more programs that add additional reimbursements beyond original medicare. Original medicare was not designed to cover all care, but to supplement. Over the years there are many other plans added ad Medicare Advantage Plans, like HMOs, PPOs etc. which require additional cost to the recepients but many are no cost. In addition there are cost plans, medigap etc. which add to reimbursement rates. There is also Medicare Part D, Prescription Coverage. However, many people on medicare have not through ignorance or choice, not enrolled in these plans.

Some people have different priorities for their lives and they will pay for a Bronco Game but not for these additional programs. Of course these are the same people who say they cannot afford auto insurance but can go to a bar, every night.

Many of these programs are free. I am on Medicare and I pay a small amount for additional coverage on a Medicare Advantage Plan, but there is also an option for a no cost additional coverage.

You cannot argue that these people are poor and cannot afford to pay extra--remember some are free. In addition low income are provided lower cost or no cost Part B Medical Insurance, which you continue to pay when on medicare. Also, they are supplemented with Part D Prescription Drug Coverage costs and are given more coverage for less cost when Medicare is provided with Medicaid. To round it out Part A is Hospital Insurance.

Yet, people do not enroll in these programs and are upset because a doctor refuses them care. Many doctors are part of a HMOs, PPOs etc which provide medicare programs. Even though they will not take more or any original medicare plan patients--they will take medicare patients enrolled in these plans; as long as they are part of the network--they cannot refuse care based on reimbursements. All medicare enrollees cannot be refused coverage under a Medicare Advantage Plan--except for end stage renal failure, which has special plans.

All these plans are available all over the country. Yet some people have not joined because they feel that some of these plans, not all, reduce your choice of doctors--that is not always true--there are many doctors on all plans. And some plans like medigap and cost plans do not have a network of doctors.

There are some less populated and rural areas of the country, that are not well served by all plans, but there are still other plans available in addition to original medicare. When you are older and near retirement--you better think about were you are going to live--to be near hospitals, diagnostic services, trauma centers, doctors and available insurance----it is all about choices.

All this is very complicated to say in one post. What I am saying, when you retire, it will be advantageous to you to learn and understand medicare so you can get the best care that you need. However, it is about choices and you have to make the best choices for you, as I have and I
Livecontent

[CO_Rider]

Originally Posted by livecontent

.........................
Yet, people do not enroll in these programs and are upset because a doctor refuses them care. Many doctors are part of a HMOs, PPOs etc which provide medicare programs. Even though they will not take more or any original medicare plan patients--they will take medicare patients enrolled in these plans; as long as they are part of the network--they cannot refuse care based on reimbursements. All medicare enrollees cannot be refused coverage under a Medicare Advantage Plan--except for end stage renal failure, which has special plans.

Your last sentence in the above paragraph is not completely true.
What I have found out locally is that you CAN be refused by Doctors if you are on a Medicare Advantage Plan. Unless that Medicare Advantage Plan happens to be Rocky Mountain HMO which charges a premium that is totally unreasonable. The Doctors that I have applied to do take Medicare patients but they are limiting the number.

Yes it is true that Medicare patients are old and SOME may require lots of attention by a Doctor. Our now retired former Internist needed to see me only every 6 months to make sure my prescribed blood pressure medication is still doing the job. My wife only needed to check in with him once a year. Doesn't take much time for that.
I refuse to pay exorbitantly high premiums to Rocky Mountain HMO for such infrequent Doctor visits. I do have secondary health insurance but it only kicks in for what Medicare doesn't pay after a large deductible is met. I also have Part D but that has nothing to do with getting a Doctor.

My wife and I still have access to our other "Specialist" Docs with Medicare and of course to Hospital care. We just need an Internist and if you are on Medicare and planning to move to the Grand Junction area you can expect the same thing. If there were MORE Internists here, that would solve the problem.

In the meantime we just keep calling and hoping there is an opening.

[multitrak]

Originally Posted by CO_Rider

<snip> If there were MORE Internists here, that would solve the problem.

i looked here Medicare.gov - Participating Physician Directory - Search and found 35 internists who accept medicare assignments in gj. are you telling us that none of those 35 doctors listed there accept new patients? that seems a bit weird if true...

[CO_Rider]

Originally Posted by multitrak

i looked here Medicare.gov - Participating Physician Directory - Search and found 35 internists who accept medicare assignments in gj. are you telling us that none of those 35 doctors listed there accept new patients? that seems a bit weird if true...

Please read carefully what I mentioned before. Yes, they will accept new patients that have Rocky Mountain HMO Medicare Advantage plan.

Otherwise, one can be placed on a call back list and wait. That is what we do. We know one family that waited for a year to get called back saying they will now take them on Medicare.

A large number of folks go to the town of Delta (30 miles from GJ) to be accepted.

If we had known 4 months earlier that our Doc was retiring we could have got in with a Doc just 2 miles from our house. This Doc had just stopped taking new patients on Medicare.

I am not making News since this was thoroughly discussed in the Grand Junction Daily Sentinel. It is a well known problem and us "Seniors" discuss and cuss it all the time.

[livecontent]

Originally Posted by CO_Rider

Your last sentence in the above paragraph is not completely true.
What I have found out locally is that you CAN be refused by Doctors if you are on a Medicare Advantage Plan. Unless that Medicare Advantage Plan happens to be Rocky Mountain HMO which charges a premium that is totally unreasonable. The Doctors that I have applied to do take Medicare patients but they are limiting the number.

You are not reading my post correctly I said "[/All medicare enrollees cannot be refused coverage under a Medicare Advantage Plan--except for end stage renal failure, which has special plans." and that is correct--that is enrolling in a plan for coverage--not getting care from a doctor. Rocky Mountain HMO is a Medicare Advantage Plan--they cannot refuse you coverage. However, the doctors can refuse coverage--but if they are a provider member of a group plan--there are limited reasons to refuse new patients.

Yes it is true that Medicare patients are old and SOME may require lots of attention by a Doctor. Our now retired former Internist needed to see me only every 6 months to make sure my prescribed blood pressure medication is still doing the job. My wife only needed to check in with him once a year. Doesn't take much time for that.

I am talking about you specifically. I am talking about the the complete population of Medicare patients which indeed require more intensive care---as a group--sure there are exceptions but eventually all medicare patients require more care because of the diseases of age and disability. So doctors have to keep their medicare patients at a good manageable mix in their practice.

I refuse to pay exorbitantly high premiums to Rocky Mountain HMO for such infrequent Doctor visits. I do have secondary health insurance but it only kicks in for what Medicare doesn't pay after a large deductible is met. I also have Part D but that has nothing to do with getting a Doctor.

"I am not saying that all additional coverage is the same for value--I was pointing out that these programs exist and people should be made aware of them. In addition, there are more programs available in larger populated areas. I am aware of Rocky Mountain Medicare program, I did not choice it--but in the Denver Metro area, there are many more competitive medicare plans. I do agree that Rocky Mountain Medicare programs are costly but they have some of the top approvals for service from enrollees, in Colorado.

My wife and I still have access to our other "Specialist" Docs with Medicare and of course to Hospital care. We just need an Internist and if you are on Medicare and planning to move to the Grand Junction area you can expect the same thing. If there were MORE Internists here, that would solve the problem.

That is an issue with smaller populated areas that people do not think about before they retire and seek medicare.

In the meantime we just keep calling and hoping there is an opening.

It can even be worse when a doctor takes all patients, just to have more money paying customers and gives substandard care to all because he cannot handle the patient load. It is better for all that doctors keep their practice to a manageable level.

Livecontent