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Old 11-23-2008, 02:51 PM
 
2,672 posts, read 3,761,132 times
Reputation: 2524
Default Medicare Acceptance - New Patients

I have relocated several times since retiring and lived in PA, DE, NC, SC, and now TN. I did not have any problem finding a doctor that would accept me in all those states until this year in TN. I am not sure whether it is a location or a recent trend. This year in TN I tried about twenty different medical facilities and was declined at all of them. Only two told me they were not accepting Medicare patients. The rest had me fill out and application form and when I inquired about it was told the doctor had declined to treat me without reason.
My questions; has anyone with Medicare who has relocated recently run into a similar problem and what state are you located? If you relocated recently and had no problem finding a doctor who accepted Medicare what state are you located?
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Old 11-23-2008, 02:59 PM
Status: "Fist City" (set 24 days ago)
 
Location: Los Angeles California
10,515 posts, read 9,000,538 times
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Quote:
Originally Posted by donsabi View Post
I have relocated several times since retiring and lived in PA, DE, NC, SC, and now TN. I did not have any problem finding a doctor that would accept me in all those states until this year in TN. I am not sure whether it is a location or a recent trend. This year in TN I tried about twenty different medical facilities and was declined at all of them. Only two told me they were not accepting Medicare patients. The rest had me fill out and application form and when I inquired about it was told the doctor had declined to treat me without reason.
My questions; has anyone with Medicare who has relocated recently run into a similar problem and what state are you located? If you relocated recently and had no problem finding a doctor who accepted Medicare what state are you located?

i work in san antonio, texas and find nobody having trouble with doctors taking new medicare pts.
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Old 11-23-2008, 03:43 PM
 
Location: Knoxville, TN
2,173 posts, read 4,845,541 times
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Where in Tennessee? I'm in Knoxville and have no problems at all. Baptist Hospital operates several Senior Health Centers around East Tennessee that only take older/or Medicare patients. I use an Advantage Program that's run out of Rockwood, TN, and it's been excellent. I've got a wide range of plan doctors to choose from.
If you're in a small town with limited services or not on a good Advantage program, it may be a problem, but you should have checked that first.
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Old 11-23-2008, 03:48 PM
 
6,950 posts, read 15,950,746 times
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More and more doctors are beginning to refuse to join the Medicare program. The rules and regulations and small approved payments make it very difficult for the average doctor.
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Old 11-23-2008, 04:42 PM
 
Location: In the North Idaho woods, still surrounded by terriers
2,178 posts, read 4,413,372 times
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Okay, so then...what do Medicare age folks do? Suggestions? I am not there yet, I still carry insurance myself...but I wonder what people are doing who cannot find a doctor to het RX's refilled and such? ER?
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Old 11-23-2008, 04:56 PM
 
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This is getting with more common with many doctors. It the reemburseemnt problems congress has been talking about but doing nothing about. No problems I have heard of with prescriptions tho.
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Old 11-23-2008, 06:52 PM
 
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knoxgarden,
I am in the Tri City area, northeast TN. This area has a large population of seniors which may be the main cause. Most MD's will accept TNcare here, and very few accept Medicare.
I have Medicare and BCBS and have still have had troubles.
I leased rather than buying and I think I will be moving at the end of my lease mainly because of this medical service issue.
Don
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Old 11-23-2008, 09:47 PM
 
4,749 posts, read 8,339,550 times
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Quote:
Originally Posted by esselcue View Post
Okay, so then...what do Medicare age folks do? Suggestions? I am not there yet, I still carry insurance myself...but I wonder what people are doing who cannot find a doctor to het RX's refilled and such? ER?
The whole issue is very confusing but there are options. You do not want only to have original medicare---it pays very little and you will have to find providers that accept the services.

Medigap Plans that provide the services that medicare does not cover but finding a provider is still problematic. These Plans are older plans and Medicare is trying to move people into Medicare Advantage Plans.

The best way is to sign up for a Medicare Advantage Plan, specifically a PPO (Preferred Provider Organization) or an HMO (Health Maintenance Organization) type plan. You cannot be turned down and you will be provided with a list of providers that have agreed to accept the specific plan and members enrolled in the plan. Doctors can and do refuse new patients because of patient load but are not as likely to refuse because of fees. PFFS (Private Fee-for-Service) is also a Medicare Advantage Plan and has different rules where you must find providers to accept the fees.

Medicare Advantage Plans are the best value in Medicare, but you are required to get all your care through the insurance provider, even though you are still considered under medicare.

I am covered under Kaiser Senior Advantage, A Medicare Advantage Plan (HMO) in Colorado. This plan has their own providers and so there is no problem in finding care.

Livecontent
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Old 11-24-2008, 07:00 AM
 
13,519 posts, read 22,160,478 times
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I think it is a sign of the times, when I lived in Tampa and had CIGNA, I had several doctors quit taking CIGNA because of what they paid the drs. I live in a small town now and I found that most doctors here are not accepting new patients and I am not on medicare yet!

I go on medicare in Jan. and I am going with BCBS advantage plan (I think) rather than my employer benefits because of the cost. I like the advantage plan because you have no co-pay except for drugs. You don't have to file anything.. I checked the doctors in my area and the few I know are listed. I think Drs. prefer it as they don't have to bill medicare they are paid directly by the advantage plan.

As always, Livecontent has provided excellent information. I went to this site to see the different plans in my area plus estimated cost according to your health.
http://www.medicarenewswatch.com
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Old 11-24-2008, 08:30 AM
 
Location: Knoxville, TN
2,173 posts, read 4,845,541 times
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I really like my Advantage plan. I've never tried to use just Medicare. That's all percentages and that scares me. I wanted fixed costs.
I use a small plan that just covers East Tennessee, parts of the Carolinas and Arkansas. Keeps costs down.
The doctors that are on the plan are excellent and I don't need a referral to see specialists. It includes drug coverage and has the drugs I need.
You do need to check formularies to see if the drugs you take are covered. You can do that on the medicare.gov site.
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