Physicans do not accept new Medicare patients

[avi123]

In my area of the country it is almost impossible to find primary care physicians who accept new patients that are on Medicare plans.

See this example in which they don't have a plain Medicare as an approved insurance.

https://www.novanthealth.org/home/patie ... tance.aspx

I think that I have a Medicare Advantage Plan:

https://www.medicare.gov/your-medicare- ... plans.html

I called one of Novant's branches for an appointment and was told that their policy about accepting new patients who are on Medicare is a 6 months wait. It also refers to seeing specialist physicians.

Given the fact that OSA seriousness is more prevalent in more advanced age individuals, any suggestion that you may give on this website to go check with "your PCP, Sleep Doc, etc", without knowing the member's age and if he/she is on Medicare, seems to be useless. The only choice that such a person has is to locate an older time physician or go to a public hospital emergency dept.

[SewTired]

I think you are misunderstanding that list. If you look in the list designated for Medicare, they are referring to the SUPPLEMENTAL plans that they accept. Of course they take Medicare or they wouldn't accept supplemental plans.

One thing that isn't actually stated in the list is that they won't accept supplemental policies from other states. In other words, snowbirds are SOL. They will have to pony up for that 20%. It may BE because of snowbirds that they have this policy for new patients.

It IS true that in some parts of the country, there are medical groups who refuse Medicare as a means of payment. I won't comment further on it as I don't know anybody personally affected by it. I'm mostly affected by the fact that we have more physicians retiring in the next few years than physicians graduating as family practitioners losing consistency of care. My disabled bro has had three new primaries just this year alone and his specialist doctors are retiring at the end of the year.

Now, as far as the wait, that is not unusual actually. Patients on all government programs, even Tricare, often have to wait longer to get an appointment at a specialist because the doctor's office can only afford to accept so many due to the lower pay schedule. If your situation was urgent and threatening, your doctor contacting the specialist changes all that.

[avi123]

I think you are misunderstanding that list. If you look in the list designated for Medicare, they are referring to the SUPPLEMENTAL plans that they accept. Of course they take Medicare or they wouldn't accept supplemental plans.

Hi, I told Novant's employee who answered the phone that I have Medicare Advantage plus BCBS supplement plan F. She said that they can't give me an appointment as a new patient.

BTW, I pay more than $400 monthly for these policies which include Blue Medicare Rx Enhanced (PDP). These are top policies for retirees who are not on company health plan. Other Medicare policies such as by AARP cost less but are more limiting.

There are posters on this board who keep sending members to physicians without knowing if the members can do it financially.

[chunkyfrog]

. . . 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!

[Lucyhere]

I think you are misunderstanding that list. If you look in the list designated for Medicare, they are referring to the SUPPLEMENTAL plans that they accept. Of course they take Medicare or they wouldn't accept supplemental plans.

Hi, I told Novant's employee who answered the phone that I have Medicare Advantage plus BCBS supplement plan F. She said that they can't give me an appointment as a new patient.

BTW, I pay more than $400 monthly for these policies which include Blue Medicare Rx Enhanced (PDP).

There are posters on this board who keep sending members to physicians without knowing if the members can do it financially.

I may be misunderstanding what you are saying... but, I'm sure that you aren't allowed to have a Medicare Advantage Plan AND a supplemental plan (plan F). You CAN be on straight Medicare AND have a supplemental plan.

[LSAT]

I think you are misunderstanding that list. If you look in the list designated for Medicare, they are referring to the SUPPLEMENTAL plans that they accept. Of course they take Medicare or they wouldn't accept supplemental plans.

Hi, I told Novant's employee who answered the phone that I have Medicare Advantage plus BCBS supplement plan F. She said that they can't give me an appointment as a new patient.

BTW, I pay more than $400 monthly for these policies which include Blue Medicare Rx Enhanced (PDP).

There are posters on this board who keep sending members to physicians without knowing if the members can do it financially.

I may be misunderstanding what you are saying... but, I'm sure that you aren't allowed to have a Medicare Advantage Plan AND a supplemental plan (plan F). You CAN be on straight Medicare AND have a supplemental plan.

+!

[avi123]

yes, I am on straight Medicare AND have a supplemental plan. They call the supplemental "Blue Supplemental".

[Grace~~~]

This is very interesting to me as I unwillingly have gotten a crash course in doctors after managing to go my entire life with just dentists.

I am very far away from social security and medicare and I've been hearing my whole life that it won't be in existence after the baby boomers are done with it.

~~~totally never occurred to me that I might not make it to be available to know?

I am in hospitals constantly it seems for hours on end and I don't have a smart phone and I don't knit and I don't take mind altering drugs (yeah - really - lol so change the lens on my horrible way of speaking)

...so instead I just pay attention.

It's something I was always good at ... (in my 'previous life unaware of things like insurance or illness)

I hear and see things all the time that freak me OUT!

A little of it about medicare ...

I was told last week during an entire day at a FLORIDA (highest ranked in State ... unranked in nation)
hospital that the reason things are so VASTLY different here than they are in Manhattan is because of the retirees and snowbirds.

I pay over $900 a month and I did all those years where I never used one cent.
No kids. No one used a penny. Well ... I did break my arm once? Maybe that went
above deductible? IDK ... not sure.

(Business Owner)

...and that was/is pretty much a catastrophic policy.
(Did I jinx myself? Stupid catastrophe )

I pay enormous amount of deductible now.
I could buy a small Florida Condo or a handful of 55+ community mobiles for my deductible each year.

The reverse silver lining to living is that at some point I am going to know all the financial damage along with the damage to my body from being a 'survivor'.

I have no idea how medicare effects folks now?
I have no idea how it may work in 20 years?

[Lucyhere]

yes, I am on straight Medicare AND have a supplemental plan. They call the supplemental "Blue Supplemental".

Ok... then when you said something about a Medicare Advantage Plan to the employee you spoke to, you confused that person. When you call to inquire/or attempt to make an appointment with a doctor, etc., don't ever mention a MAP, because you aren't on one. You simply say... I'm on Medicare and I have a supplemental policy with BCBS (plan f). It's unfortunate, but folks with Medicare and a supplement policy have a better chance of getting an appointment with a doctor of their choice than someone who has a MAP.

[avi123]

yes, I am on straight Medicare AND have a supplemental plan. They call the supplemental "Blue Supplemental".

Ok... then when you said something about a Medicare Advantage Plan to the employee you spoke to, you confused that person. When you call to inquire/or attempt to make an appointment with a doctor, etc., don't ever mention a MAP, because you aren't on one. You simply say... I'm on Medicare and I have a supplemental policy with BCBS (plan f). It's unfortunate, but folks with Medicare and a supplement policy have a better chance of getting an appointment with a doctor of their choice than someone who has a MAP.

Reply:

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.

This Novant branch is:

https://www.yelp.com/biz/novant-health- ... ake-forest

They are a couple of Osteopathic physicians named: Dr Gina Micchia and Dr. Joe Micchia.

Open Monday to Friday to 5 pm.

It was about a month ago.

Presently, I think that I need to see one of the neurologists that I know. I want to ask him about trying out
Provigil or something similar to reduce my brain fogginess during the afternoon. Do you know anything about it?

http://www.goodrx.com/blog/provigil-vs- ... leepiness/

[avi123]

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

[sptrout]

yes, I am on straight Medicare AND have a supplemental plan. They call the supplemental "Blue Supplemental".

Ok... then when you said something about a Medicare Advantage Plan to the employee you spoke to, you confused that person. When you call to inquire/or attempt to make an appointment with a doctor, etc., don't ever mention a MAP, because you aren't on one. You simply say... I'm on Medicare and I have a supplemental policy with BCBS (plan f). It's unfortunate, but folks with Medicare and a supplement policy have a better chance of getting an appointment with a doctor of their choice than someone who has a MAP.

Reply:

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.

This Novant branch is:

https://www.yelp.com/biz/novant-health- ... ake-forest

They are a couple of Osteopathic physicians named: Dr Gina Micchia and Dr. Joe Micchia.

Open Monday to Friday to 5 pm.

It was about a month ago.

Based on what you have provided and the providers own website, they say that they accept Medicare Blue even one of the doctors that you mentioned. So, I don't understand why they are rejecting you unless they have changed their policy regarding Medicare. You may want to ask to talk to a person in their billing department, they would know for sure. The call taker that you have spoken to may be confused.

[avi123]

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

[Jeannh]

told Novant's employee who answered the phone that I have Medicare Advantage plus BCBS supplement plan F. She said that they can't give me an appointment as a new patient.

Practices can close their patient panel if they are too full in some states (e.g.: CA). But, they cannot close it ONLY to seniors - it's all or nothing. They can also refuse Medicare "assignment", meaning they do not accept payment for traditional Medicare (A, B, D) from the federal government. There are fewer and fewer of these physicians, however, with 11,000 people a day turning 65.

Only traditional Medicare can add on a supplemental plan (A-N, often called supps or MediGap plans). If you don't have a Part B copay (which would indicate traditional Medicare) you cannot have MediGap plan, and anyone who charges you for one should refund any premium you have paid while on a Medicare Advantage plan. If they don't, I would contact you elected state representive or Cms.gov. Cms.gov also has good general information.

Medicare Advantage is essentially a Medicare HMO, controlled by a private insurance company. It may have slightly different benefits, will likely include generic medications and will absolutely have a restricted network. If you are an individual (meaning you do not get your insurance via an employer retiree plan), you are in the middle of "open enrollment". You have until Dec 15 to choose a Medicare Advantage plan, or move back to traditional Medicare. After that, you have to wait another year to make a different choice.

Hope that helps. I know it can be frustrating. You can likely also find a local broker who can lay out the options in your area.

[Lucyhere]

This is what I would do: I would call the Novant branch tomorrow and ask for a Supervisor /Director/head of the clinic, etc. Tell them immediately you have Medicare with a Supplemental Policy - BCBS plan f. I would bet you a nickel that they take Medicare. I think the mix up was because you mentioned a Medicare Advantage Plan. From what I see on the link you posted, they DO take Medicare and your supplemental policy. And, in the future, be sure not to say anything about a Medicare Advantage Plan because you don't have a MAP.

About the Provigil, I've never taken it so can't comment.