If you receive Medicare and/or Medicaid, it can often be difficult to find a doctor, whether it’s a general practitioner or a specialist, who will accept your insurance. Unfortunately, government-mandated payment schedules have resulted in many physicians opting out of the system because they simply cannot afford the substantially lower payments for Medicaid/Medicare services, as well as the substantially increased paperwork involved. receive these patients.
Unfortunately, the government has had a tendency to reduce reimbursement payments, not increase them, and does not seem interested in covering the true cost of providing services.
Not only that, but private insurers are no longer willing to “subsidize” public patients by paying higher rates, so doctors can’t pass the increasing costs on to them.
As a result, at a time when more and more doctors are opting out of the system, doctors who are still accepting Medicare and Medicaid patients typically limit the number of patients they see, so it’s not hard to find a doctor who will accept your Medicare or Medicaid insurance. as easy as simply opening the phone book and making a phone call. In fact, it will probably take some time and effort on your part.
There is not, and never has been, any requirement for physicians to treat patients insured by Medicare or Medicaid. So people with Medicare or Medicaid are increasingly turning to federally funded clinics, or even emergency rooms that, by law, can’t turn them away. Unfortunately, using ERs for non-emergency medical care is incredibly expensive, making the lower Medicare/Medicaid reimbursement rates financially unsound in the long run.
So how do you find a doctor who will accept new Medicare/Medicaid patients?
Well, first of all, don’t expect to find a doctor or, if you do find one or a clinic that accepts Medicare/Medicaid patients, don’t plan on getting an appointment quickly. Unfortunately, that won’t happen very often. In fact, if you need care fast, the ER may be your only recourse.
To locate Medicare/Medicaid providers, you can contact your local health department or social service agencies for more information, and there are several online Medicare and Medicaid physician directories. While they cannot guarantee you an appointment, they do have access to information on current providers.
You can also visit the Medicare website at Medicare.gov or call them at 800-633-4227 (TTY 877-486-2048) to find Medicare providers in your area, although there is no guarantee they are accepting new patients. However, it is worth a try.
Also, managed care is probably a better bet than private practice. HMOs organized by private insurers have a practical interest in having HMO doctors care for government-insured patients, while Prepaid Health Plans (PHPs) are typically run by hospitals or medical schools and often by they only accept Medicaid patients.