Once they turn 65 years of age, Americans qualify for Medicare – which is a federal health insurance program started under the United States Social Security Administration (SSA) that is now administered by the U.S. Centers for Medicare & Medicaid Services (CMS). Some younger people with disability status as determined by the SSA are also eligible for assistance.
Choosing the right Medicare plan for you is important, but finding a doctor near you who accepts Medicare is just as vital. While you can see a doctor who doesn’t accept Medicare if you choose, you may be charged a much higher rate for your visit and for any medical services you receive. By choosing a doctor who accepts Medicare, you can be sure you are being charged an acceptable rate.
Whether you are looking for a new doctor, a clinic, a hospital, or you simply want to keep the doctor you are already seeing, finding out who takes Medicare is a priority. Let’s talk about how best to search successfully for a Medicare provider, and where you can go near you in Florida for outstanding medical care.
How the Type of Medicare Plan You Have Affects Your Choice of Doctor
Depending on the type of Medicare plan you have, you may or may not need to stay within a provider network. With original Medicare (Part A for hospital coverage, Part B for medical coverage), there are no networks, which means you simply need to ask a given doctor’s office whether the doctor accepts Medicare. If you have Medicare Part C (Medicare Advantage), it is likely that you will have to stay within your particular plan’s network of physicians.
If you have Medicare Advantage under a Health Maintenance Organization (HMO), you will receive a list of in-network medical providers from whom you can choose. However, if instead, you decide to select a healthcare provider who is out of network, you will incur a higher cost or have to pay the full out-of-pocket amount for services.
On the other hand, if you have Medicare Advantage under a Preferred Provider Organization (PPO), you’ll have a bit more leeway in choosing your doctor. While you are still dealing with a network, you will pay less for medical services if you use an in-network doctor, and you will pay more (but not usually the full amount) if you use an out-of-network doctor. PPO plans generally cost more than HMO plans because you’re paying for the extra flexibility.
Where to Find a Doctor Who Accepts Medicare
Finding a doctor who accepts your Medicare plan is relatively simple. Ways to do so include:
- Checking the official Medicare website. Medicare.gov enables you to locate healthcare providers and facilities that accept Medicare near you. There, you’ll find names of doctors and can compare healthcare providers, and you can also search for specific medical services covered by your Medicare plan.
- Reviewing your insurance company provider listings. Both Medigap and Medicare Advantage are Medicare plans that are provided through private insurance companies. These companies have been approved as official Medicare providers by CMS. Check with your selected provider for their listings.
- Checking your insurance company’s network of doctors and hospitals. To make sure your doctor is in-network, call your insurance provider or check their website. Note: Doctors’ websites are not always up-to-date, so it is best to call if you’re interested in seeing a specific doctor.
- Asking friends and family members who also have Medicare about their healthcare providers. Is their doctor attentive to their needs? Does the practice offer appointments at convenient hours? Do they manage requests promptly and without any hassles?
Medicare Providers in South Florida and Central Florida
Palm Medical Centers is not only a Medicare health services provider, but we also have convenient locations throughout South Florida and Central Florida.
Our board-certified primary care doctors and in-house specialists provide a wide range of interdisciplinary healthcare, ranging from family medicine and pediatrics to podiatry, optometry, and psychiatry. We also have our own pharmacy and offer ancillary and diagnostic services, case management and clinical care, and even transportation to all in-house and outside specialty appointments.
Palm Medical Centers is also an affiliated ACCESS site that assists recipients of social and government programs. For example, the ACCESS and Social Worker team guides patients on filling out Medicare and Medicaid applications, renewals, food stamps, accessing meals, lower-income housing, medication, injury prevention, and caregiver services.
For more information or to make a doctor’s appointment, contact the medical center closest to you today. We look forward to serving you!