If you are approaching the age of 65 and wondering if you will be able to maintain your present doctor when you switch to Medicare, the answer is “probably.” The majority of doctors in the United States accept Medicare. However, before you turn 65, you should establish whether your doctor accepts Medicare, as some doctors who accept Medicare may not accept new Medicare patients. It’s also important to examine if you’ll be enrolling in Original Medicare, Medigap, or a Medicare Advantage plan, as this can affect your choice of doctor.
Original Medicare allows you to keep your doctor as long as they accept Medicare assignment and accept new Medicare patients. You do not have to choose a primary care doctor, and you do not need a referral to see a specialist. However, it is always a good idea to check with your doctor to see if they accept Medicare assignment and are currently accepting new Medicare patients.
A Medigap (sometimes called “supplement”) plan allows you to receive medical services from any provider in the United States who accepts Medicare.
If the doctor accepts Medicare, your Medigap plan will often pay the doctor directly. Most doctors participate in the Medicare program, therefore Medicare patients can maintain their doctor as long as the physician takes part in the Medicare program.
For HMO Medicare Advantage plans, using in-network healthcare providers is typically required. Going out-of-network may result in uncovered costs. PPO Medicare Advantage plans offer more flexibility but still require checking if your doctor is in-network. Before choosing a plan, ask for a provider network list to ensure your doctor is included. Remember to check the network annually as providers may change.
In conclusion, as you approach the age of 65 and consider your options for Medicare, it’s important to assess your healthcare needs and choose the plan that best aligns with your preferences and the ability to keep your current doctor. Always verify with your doctor and a certified Medicare agent to ensure you can maintain the valuable connection you have with your healthcare provider.
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