Medicaid Doctors and Medicare Doctors: How to Find Them
If you are on Medicare and/or Medicaid, you are probably finding it difficult to find a doctor who will accept your insurance, whether you are looking for a specialist or a general practitioner. Many doctors have unfortunately opted out of the system because they can't afford either the lower payments they'd receive for their services, as set up in the government payment schedules, or the cost of the additional paperwork involved for Medicare patients.
It's sad but true that the government has tended toward reducing what they pay out to doctors rather than increasing it, and it simply doesn't cover the actual cost of services.
In addition, doctors can no longer rely on being able to shift the ever-increasing costs of their services to private insurance companies, who are backing away from "subsidizing" public patients.
Consequently, while there are fewer doctors in the system, those who still do take Medicare and Medicaid patients are limiting the number they'll take on, so it just isn't as easy to find a doctor, if you're a Medicare/Medicaid patient, as looking up a phone number and making a call. As a matter of fact, it will no doubt entail quite a bit of time and effort.
Doctors simply aren't, and never have been, required to treat patients who are insured by Medicare or Medicaid. People insured by Medicare or Medicaid are going in greater numbers to federally funded clinics and even emergency rooms, which are legally obligated to treat them. However, taking non-emergency health issues to the emergency room is extremely expensive, which makes the lower Medicare/Medicaid reimbursement rates a very unwise financial strategy for the long term.
So it's time to find a doctor who will take new Medicare/Medicaid patients--how are you going to do that?
The first thing to realize is that even if you do find such a doctor or a clinic, you'll not likely get an appointment quickly. That just doesn't happen very often, unfortunately. Your only option, if you need immediate care, might just have to be the emergency room.
To locate Medicare/Medicaid providers, your local health department or social service agencies offer both online and offline physician directories, along with additional helpful information. They'll be able to provide you with information about current providers, but they cannot guarantee you an appointment with any specific physician or clinic.
Medicare.gov, the national Medicare website, is also an excellent resource for finding local providers, and you can also call them at 800-633-4227 (TTY 877-2048); but again, they cannot guarantee these providers will be accepting new patients. But it's definitely worth a try.
You'll also probably have better luck with managed care, as opposed to private practice. Health Maintenance Organizations (HMOs) are managed by private insurers and prefer their doctors to take government-insured patients, while Prepaid Health Plans (PHPs) are usually run by hospitals or medical schools and typically only take Medicaid patients.
It's sad but true that the government has tended toward reducing what they pay out to doctors rather than increasing it, and it simply doesn't cover the actual cost of services.
In addition, doctors can no longer rely on being able to shift the ever-increasing costs of their services to private insurance companies, who are backing away from "subsidizing" public patients.
Consequently, while there are fewer doctors in the system, those who still do take Medicare and Medicaid patients are limiting the number they'll take on, so it just isn't as easy to find a doctor, if you're a Medicare/Medicaid patient, as looking up a phone number and making a call. As a matter of fact, it will no doubt entail quite a bit of time and effort.
Doctors simply aren't, and never have been, required to treat patients who are insured by Medicare or Medicaid. People insured by Medicare or Medicaid are going in greater numbers to federally funded clinics and even emergency rooms, which are legally obligated to treat them. However, taking non-emergency health issues to the emergency room is extremely expensive, which makes the lower Medicare/Medicaid reimbursement rates a very unwise financial strategy for the long term.
So it's time to find a doctor who will take new Medicare/Medicaid patients--how are you going to do that?
The first thing to realize is that even if you do find such a doctor or a clinic, you'll not likely get an appointment quickly. That just doesn't happen very often, unfortunately. Your only option, if you need immediate care, might just have to be the emergency room.
To locate Medicare/Medicaid providers, your local health department or social service agencies offer both online and offline physician directories, along with additional helpful information. They'll be able to provide you with information about current providers, but they cannot guarantee you an appointment with any specific physician or clinic.
Medicare.gov, the national Medicare website, is also an excellent resource for finding local providers, and you can also call them at 800-633-4227 (TTY 877-2048); but again, they cannot guarantee these providers will be accepting new patients. But it's definitely worth a try.
You'll also probably have better luck with managed care, as opposed to private practice. Health Maintenance Organizations (HMOs) are managed by private insurers and prefer their doctors to take government-insured patients, while Prepaid Health Plans (PHPs) are usually run by hospitals or medical schools and typically only take Medicaid patients.