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Doctor I was seeing no longer accepts Medicare?

+1 vote
I have been under the care of an OB/GYN for the past two and a half years.  I wear a Pessary for a Prolapsed Uterus.  I called the office for an appointment to see the Doctor for the Pessary and I was told he will no longer handle my case because he does not accept Medicare.  I was referred to the other Doctors in the Practice there.  I have confidence in this Doctor and I am not interested in having these other Doctors care for me.


What should I do??

asked Nov 15, 2012 in Health Insurance by anonymous
recategorized Nov 16, 2012 by knowledge-girl

2 Answers

+4 votes
If you can talk to the doctor personally, he might can make provisions for you, but probably medicare will not pay him. You probably will have to get another doctor from the practice. At least there are some there who will accept medicare.
answered Nov 17, 2012 by southernwave Inquisitive Expert (26,730 points)
+3 votes
Even a doctor who does not "accept" Medicare can see Medicare patients and help you get the fees at least partly paid by your plan.  You might have to pay his fees from your own pocket, and then get paid back by Medicare.  His office should submit the Medicare claim for you and they can't charge you for doing this.  You can submit the claim to Medicare yourself.  Medicare has a claim form on its website: Form CMS-1490S.

Since he is not "participating" with Medicare, he is allowed to charge you up to 15% more than what Medicare pays to non-participating providers.  This 15% limit does not apply to all services, however.  You can call the plan to find out the details.
answered Jun 14, 2013 by LRiddell Member (660 points)
edited Jun 14, 2013 by LRiddell


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