If you are 65 or older and are enrolled in a Medicare program, you’ll want to take full advantage of your benefits. To do that, you’ll first need to not only be sure that your current or prospective primary care physician (PCP) accepts Medicare, but also that your type of Medicare plan covers the medical services you need.
While your primary care physician may not be an expert on Medicare coverage, the doctor does know you and your health history, so you can feel free to ask questions about what your plan covers.
Let’s talk about some of the things you should find out from your physician about what is covered under Medicare, and where you can go in South Florida and Central Florida to see a top-notch primary care physician who does accept Medicare.
What Should I Ask My Doctor About Medicare?
Here are some important Medicare-related questions you should ask your healthcare provider:
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Do you accept Medicare?
If you are planning to see a new primary care physician, call the doctor’s office in advance and ask whether they accept your coverage. You can also refer to your health plan’s website to view their provider directory. However, keep in mind that these online lists are not always up-to-date.
If you are on original Medicare, which has no networks, you simply need to ask the doctor’s office whether or not they accept Medicare. If you have Medicare Part C (Medicare Advantage), it is likely you will need to stay within your particular plan’s network of physicians.
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Does my Medicare plan cover the services I need?
All private health insurance plans offer the same set of essential health benefits, such as basic prescription drug coverage, emergency services, and prenatal, maternity, and newborn care. Some of them may also offer additional coverage for a higher cost of the plan. Contact your plan provider if you have questions about whether a specific service you need is covered.
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What will your costs be, if any?
Most Medicare health plans offer the best deal on medical services when you see a doctor who is an “in-network” provider, meaning they have a contract with your particular health plan. You may be allowed to visit an “out-of-network” provider – a doctor who doesn’t contract with your plan – but you will then likely incur more out-of-pocket expenses.
Avoid any unexpected costs prior to your appointment by finding out which services in your plan are not subject to your health insurance deductible. Some Medicare plans charge only a copayment for primary care visits before you meet your deductible.
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Are my prescription drugs covered by Medicare?
Fortunately, most Medicare plans offer prescription drug coverage (Part D). However, you may want to talk with your doctor and ask for a list of the drugs you are taking, so you can find out whether your medications are covered by the plan you have or are considering.
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Are additional preventive healthcare measures covered by my Medicare plan?
While basic preventive care and screening services are covered by Medicare, your doctor may know whether additional preventive measures are covered by your Medicare plan. If not, ask your plan provider about your options.
Medicare Health Services in South Florida and Central Florida
Palm Medical Centers is a Medicare health services provider, and we have locations throughout South Florida and Central Florida for your convenience. Our medical team is highly experienced and knowledgeable, and we also have our own pharmacy to fill your Part D prescriptions.
For more information or to schedule an appointment with one of our Medicare doctors, contact us today at the Palm Medical Centers location near you. We look forward to being your healthcare partner!
