Last Updated on
Do you have a long time doctor who knows you well?
Having the same doctor over the years mean he or she already knows your medical history. It is an advantage because you are already comfortable sharing your thoughts about your health with that certain doctor.
Soon, you are going to enroll in Medicare, right?
Probably, there’s a lot of questions running in your thoughts right now.
No worries, it is understandable.
Medicare is quite confusing.
As you dig right into different Medicare options, you will come across Medicare supplement plans or Medigap. It can provide additional coverage which will give you protection against high out-of-pocket expenses.
Medicare supplement may save you more money by minimizing your out-of-pocket healthcare expenses.
But the question is, do all doctors accept Medicare supplement plans?
Will your longtime doctor accept Medigap?
Are Medicare supplement plans accepted by all doctors?
No. Not all doctors accept Medicare supplement plans, but it is very rare. Medigap insurance plans follow and utilize the doctors or medical practitioner that accepts Medicare.
You don’t have to bug out of here or from Medigap easily, just because the answer is a no.
There’s more information you need to know.
Medicare supplement plans are not a stand-alone kind of health insurance. It works by paying the healthcare expenses left or not paid by Original Medicare. So, for Medigap to work, one should be on Medicare first.
Since, Medicare supplement plans utilize the network of doctors and medical providers of Medicare, all doctors who accept Medicare should also accept your Medicare supplemental insurance.
So, the only time that a doctor will not accept your Medigap is when he or she does not participate or accept Medicare, which is very rare.
Do you dig?
Can I go to any doctor with a Medigap plan?
Yes. You can go to any doctor provided that he accepts Medicare. It is best to ask your medical provider first if he accepts Medicare to avoid rejection of payment during your appointment.
If the doctor accepts Medicare, it means they agree that they will not charge you more than your share of the cost (coinsurance or copayment). You usually pay for the coinsurance or copayment out of your pocket, but if you have a Medigap, the policy will pay all or part of the amount depending on the type of plan you have.
What if my doctor doesn’t accept Medicare assignment?
Medicare assignment is a term used to determine if the doctor accept Medicare as payment in full. Doctors who accept Medicare assignments means that he agrees to the amount, payment schedule for services or procedure set by Medicare.
Fact: 95% to 96% of doctors accept Medicare.
Only a few percentages of doctors, mostly specialist, does not accept Medicare assignments. If you visit them for consultation, they can charge you up to 15% higher than the Medicare amount. This is the Medicare Part B excess charge. The physician may also ask for payment right at the very moment of your appointment or bill you afterward. Some physicians may even ask you to file claims on your own.
Can I go to any doctor if a have a Medicare SELECT plan?
Yes, but the benefits will be much limited. To receive the Medigap benefits of a Medicare SELECT plan, you must only utilize the given network of medical providers.
Medicare SELECT plans are the only kind of Medigap that has a network but is not a very common option in most states.
What if I showed up in my appointment and find out that the doctor won’t accept my Medicare supplement plan? What should I do?
No one likes getting a rejection when you are looking forward to being accepted, right?
It is disheartening if you showed up at your doctor’s appointment only to find out that they won’t accept payment from your Medigap policy.
What would you do?
For this round-up, we asked around and gathered the thoughts of Medicare supplement experts to know what they think happened and what should the person do in the situation.
Here are the answers:
If that doctor accepts Medicare they MUST ACCEPT the supplement as it is federal law. But make sure the individual doesn’t have a Medicare Advantage plan as they work differently.
If the Dr accepted Medicare, they will also accept and bill any Med sup carrier. Medicare supplements are not to be confused with advantage/ HMO/PPO type plans
Licensed insurance agent/ broker
“If they have a Medicare supplement, all they have to do is say, “Medicare is my primary, and this is my new supplement.” End of story. If it’s a Medicare Advantage plan, then you have to go to the doctors in your network or pay out of pocket. (Also, in the early part of the year you could get a Medicare Supplement and go back to Original Medicare, if you medically qualify.)”
Independent Medicare supplement plan agent
A Medicare supplement is accepted by any doctor that takes Medicare. You don’t have to worry about networks. Medicare Advantage is another story. Those you have to check and see if the doctor accepts it.
Long Term Care Insurance, Medicare Supplements, Medicare Advantage, Farmers Insurance Property and Casualty, Annuities.
If your doctor accepts Medicare, he has to accept your Supplement (Medigap Plan). Medicare Advantage Plans are NOT Supplements. If you have a Medicare Advantage Plan, you must check if your doctor is in the network or you may not be covered.
Medicare supplement / Medicare Advantage Sales
Traditional Medicare supplements do not determine who you can see and where you can go for care.
That being said, infrequently purchased “Medicare Supplement Select Plans” can have some network restrictions, but we just don’t see any demand for those at our agency. They’re typically a non-starter with consumers.
Medicare Insurance Expert – Annuity Broker – Long Term Care, Health Insurance & Group Benefits Agent
Medicare supplement plans should be accepted by any doctor who accepts Medicare. Make sure your longtime physician accepts Medicare before you proceed with any Medicare options. Take note that Medicare supplement plans are different from Medicare Advantage plans, and should never be used interchangeably. Be sure that what you have is a Medigap policy, not an Advantage Plan because the latter has networks of doctors that you will only have to use.
If you need help in finding a Medicare supplement plan, you may request quotes from us. One of our licensed insurance agents will reach out to you to discuss your options.