Physicans do not accept new Medicare patients

library lady wrote: Maybe look into what Plan F is... I've never heard of it but I'll google it out of curiosity.

Plan F is only offered if you have Medicare and a supplemental policy with BCBS/UHC, and perhaps more ins companies I don't know of. Plan F isn't offered with Medicare Advantage Plans.

avi123 wrote:yes, I am on straight Medicare AND have a supplemental plan. They call the supplemental "Blue Supplemental".

If this statement is correct, BCBS has absolutely no say in where you get your medical care. The bullet points are:
1) If you have straight Medicare, any medical service provider that has agreed to accept Medicare must accept Medicare regardless of where you are in the US. You could go to SC, VA, NJ, etc. and it would not matter.
2) The same is true of all supplement plans - each supplement plan of each letter designation is standardized regardless of who underwrites the plan - all terms, conditions, and costs are the same regardless of who writes the policy. Insurance carriers MUST agree to payment under the terms of their contract with Medicare.
To give an example: for several years I had a condition called hemi-facial spasm that was initially diagnosed when I lived in Orlando FL; it was treated by a neurologist there. When I moved to Tarpon Springs (on the other side of the state) I continued to be treated by him without a single glitch in the process. When I came to the decision to deal with the condition with surgery, I researched the issue and found the most cutting-edge procedure had been pioneered at the University Of Pittsburg Medical Center and was widely regarded as the top of the list. When I contacted them and explained my condition and my Medicare status, they told me there would be no problems at all and that, given my supplement plan, there would most likely be zero due at discharge. I then spoke to a neurosurgeon I knew in Missouri who had gone through the fellowship program at Pitt who mentioned another Neurosurgeon in Orlando that had been in the same program as he. It turned out that my original neurologist also knew this person and made a referral (this was a courtesy and not a requirement under Medicare). The upshot of all this is the surgery was done and the condition was completely cleared up. The bill: more than $200,000; my payment: zero. My only expenses were gas to and from Orlando and a hotel for three nights for my wife.
My take on your situation is why limit your search for medical care to just Novant if other facilities are available? Examples: Wake Forest Baptist Medical Center (including the Sleep Center at the Hawthorne Inn) and Duke Health with their many sleep medicine practices, have excellent reputations. The final point for me is that under the terms of Medicare, YOU make your network; you need no referrals to see a doc and ANY and ALL docs that accept Medicare are "in network." Don't let anyone limit your getting services.

svo wrote:...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

Comment,

For some 20 years I had no problems and was treated nicely by good physicians as you are. 10 years ago (in 2005) I moved to another town about one hour drive away. To go and see those physicians from before would take me about one hour drive each way. So I am looking for physicians close to my home. But I have problems finding good ones. It seems that I made a mistake by moving to the periphery at my age. Good Doctors' clinics are concentrated near hospitals in the capital city of Raleigh. Frankly, I look for physicians who completed Duke Medical or UNC Chapel Hill.

Medicare Part A is supplied by the federal government, and is pre-paid through payroll contributions.
Medicare Part B is also provided by the federal government, and the premiums vary according to gender and location.
Medicare supplements are from various companies, and the "plan" determines what you get, and to some extent what you pay.
Note the words "part" and "plan" are not interchangeable.

library lady wrote: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.

Regarding Library Lady's statements:
Are you including in your monthly premium the monthly amount Medicare deducts from SS? If not, add that to your costs, that is the first amount insurance companies get for their Advantage Plans. Go to https://www.medicare.gov/eligibilitypremiumcalc/ to find out how much that is.
If you have an Advantage Plan you cannot add a supplement plan, it is not allowed. However, if you see yourself facing heavy medical expenses over the next few years, I would advise looking at the option of changing coverage during the open enrollment period (now thru Dec 7). You may well find benefits in getting on straight Medicare with added Supplement and Drug Plans. It is the "willing to pay the excess" part of what you said that would trouble me. That sounds too open-ended to be acceptable to me - this sounds too much like asking for a blank check and could add thousands of dollars to your out of pocket expenses. If you go to https://www.medicare.gov/find-a-plan/qu ... /home.aspx you will be able try many options on for size to see what fits your needs best. Keep in mind, with Medicare and a Supplement Plan, your available network expands dramatically.