Physicans do not accept new Medicare patients

[LSAT]

sptrout, if I have Original Medicare plus BCBS supplementary does it make a difference how I need to call it?

Medicare Advantage is supplied by an Insurance Company...Medicare is a Government program.

[JimW159]

sptrout, if I have Original Medicare plus BCBS supplementary does it make a difference how I need to call it?

Yes, words matter. In Forsyth County NC ( picked randomly), there are three different BCBS Blue Medicare Advantage plans offered: two HMOs and one PPO; each is titled BlueMedicare, followed by differentiators. If one says "I have BlueCross Medicare" the likelihood that the listener would interpret this as meaning anything other than a BCBS Medicare advantage plan would be very slim. When speaking, specificity and accuracy in naming something always minimizes the chances of a misunderstanding. To the point of having both an advantage plan from anyone anywhere AND a Medicare Supplement plan of any type is not allowed under the rules of Medicare. If one uses Medicare itself as the primary coverage, then they have the option of adding both a supplement plan and a part D plan. If the user opts for a Medicare Advantage plan they no longer have the option of adding a supplement plan and are out of the Medicare payer system. If their Advantage plan does not provide drug coverage, they may have the option of adding a separate part D plan (that is unclear to me). In my personal case, I chose to remain on straight Medicare and add a Supplement plan (level F) plus a drug plan. The benefits to me have been substantial: not all doctors and hospitals that accept Medicare accept all advantage plans - OTOH, if they accept Medicare, they accept it all; my out of pocket expenses beyond premiums for Medical and Hospital have been only the bare minimum deductible, no co-pays at all and no network restrictions of any kind. It is also fully transportable throughout the US.

[Grace~~~]

you also don't give your age, so I don't know how to reply to your post.

Hi Avi ~~~ thanks again for this thread and the little insight of what Medicare is like.

You have gotten some very educational replies.
I am sure they won't be relevant by the time I will be eligible but the "lesson" is still not being lost on me.

I think I am going to lie about my age from now on.
I always lied about being older than I was ...

I'm told it's a woman's prerogative?
I am firmly in the Gen X so that's good enough.

It seems unclear if Medicare will be available when Gen Xers reach retirement age.

...but it's very interesting to hear how it is working today.

[sleepychar]

Lucy, I said to the lady on the phone at Novant Health Partners that I am on a Blue Cross Medicare. She replied that I can't get an appointment there.

Avi,

I am on Medicare also. I think the problem is that there was a communication mix-up when you called Novant. When you say "I am on a Blue Cross Medicare", that can be misleading because Blue Cross has Medicare Advantage Plans as well as Medicare Supplemental Plans. So I think it would probably be useful, as Lucy suggested, to call back and perhaps try to talk to a Supervisor - or at least, whomever you speak to, try to clarify that you are NOT on a Medicare Advantage Plan but rather, have original Medicare plus a Medicare supplemental plan with Blue Cross. The physicians you could see if you happen to be on a Medicare Advantage Plan, which you are not, are restricted by the Advantage Plan you are on. Then, additionally, I think some physicians who may be associated with that Advantage plan further limit access by only accepting a certain number of patients from that plan. The important question for you if you have original Medicare is whether the doctor accepts Medicare assignment. That means, do they accept the amount Medicare offers to pay (if they do accept assignment) or do they charge more for visits than Medicare offers to pay (if they do not accept assignment). Let us know what happens after you call them back.

[Lucyhere]

To further this conversation ... Medicare (if they accept assignment) will pay 80%. Your supplemental policy pays 20%, which of course equals 100%.

If you were on a Medicare Advantage Plan, (which you are not), you would probably have a deductible, and for certain you would have a co-pay.

Always immediately ask if they accept Medicare. When they question you further, and they always do, tell them you also have a supplemental policy (BCBS - plan F). When you tell them that, I think you'll find that more doctors/hospitals/clinics will be available to you than you think.

[Stormynights]

When I first got on Medicare I had a horrible time finding a doctor. I did finally find one and he said the problem was with the billing. Too much paper work and getting the right codes and waiting to get paid. I never did find a doctor for my husband so he just goes to the VA. My doctor is young and just buildng his practice. If not for that and the fact that my insurance called him for me I would have nerver gotten him.

[svo]

...I think as some has explained before, if you have "straight" Medicare and a supplemental plan f (the best to have and wil not be sold after 2020...except those of us we have it will continue to have) from which ever company it is then all you need to ask is if that doctor, group or whatever accepts Medicare, if the answer is yes then the reminder 20% that Medicare (regular straight) Medicare does not cover the supplemental plan F will cover...

Medicare Advantage (also know as medicare part c )is nothing more than an HMO and it usually includes hospitals, doctors, eyecare and drugs..etc....You should nebver mentioned Medicare Advantage because as I said a lot of doctors, facilities etc do not want to deal with an HMO.

In my expiriences in NJ most doctors and facilities do like MEDICARE (straight) and if you have a supplemental, specially plan F they love it....
I had quintuple bypass saw the "bill" from hospital doctors etc for a total of over $330k...never paid a penny never saw a bill....

Good luck to you but please refer to correct name for the medicare coverage that you have...yesd Medicare Advantage can not have Plan F AT ALL

[mike1953]

. . . I told Novant's employee who answered the phone that I have Medicare Advantage plus BCBS supplement plan F.

Ha! This is IMPOSSIBLE!
Plan F supplements should not be sold to Advantage patients--ever!
Avi, you are being RIPPED OFF! This is a FEDERAL OFFENCE.
You need to contact Medicare directly.
Somebody needs to get tossed in jail!

+1 You are correct it is illegal to sell a supplement to a Advantage plan Please contact your state insurance commissioner and report this or contact your local SHIP.

[LSAT]

To further this conversation ... Medicare (if they accept assignment) will pay 80%. Your supplemental policy pays 20%, which of course equals 100%.

If you were on a Medicare Advantage Plan, (which you are not), you would probably have a deductible, and for certain you would have a co-pay.

Always immediately ask if they accept Medicare. When they question you further, and they always do, tell them you also have a supplemental policy (BCBS - plan F). When you tell them that, I think you'll find that more doctors/hospitals/clinics will be available to you than you think.

I have the AARP Medicare Advantage Plan through United Healthcare (Plan C).... For Doctors visits I have a Co-pay...no deductables. For Hospital Stays I have a co-pay...no deductables. Plan covers A, B and D. Cost is $25 per month.

[chunkyfrog]

Plan F is favored by providers because it will pay upcharges, over and above the Medicare allowables
The upcharges are limited, however, but some companies pay fairly soon after Medicare passes them the bill.

[Lucyhere]

I have the AARP Medicare Advantage Plan through United Healthcare (Plan C).... For Doctors visits I have a Co-pay...no deductables. For Hospital Stays I have a co-pay...no deductables. Plan covers A, B and D. Cost is $25 per month.

I wish that plan was available in CA. It's the best MAP out there.

[squid13]

I'm on Medicare and I tell them that my primary insurance is Medicare and my secondary insurance is Blue Cross/Blue Shield Federal and I have never had a problem, been on Medicare 14 years. Tell it like that and you will have no problems.

[chunkyfrog]

There is also the possibility that a provider declines serving certain patients because of "other" reasons.

[Lucyhere]

There is also the possibility that a provider declines serving certain patients because of "other" reasons.

Hmmm... what are some of those reasons?

[library lady]

A 6 month wait for a new primary care patient is not uncommon in urban areas, I forget where you are located. I have BlueCross/BlueShield Cost Plus Plan (MN), which is essentially a Medicare Advantage Plan with RX. I will pay $164.50/month in 2017, with excellent coverage .

Certainly some small clinics could refuse Medicare patients, but in most cases I think they accept it if you are willing to pay the excess. Maybe look into what Plan F is... I've never heard of it but I'll google it out of curiosity.