When Medicare is unusable.

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Well, it finally happened. I've heard for years that doctors were dropping Medicare, but hadn't experienced it myself. I was trying to get to see a psychiatrist, and now I find that there aren't any in this whole general area that accept Medicare. What good is it to have Medicare if no doctors don't accept it? Is this the future for Medicare patients. Somebody else had told me that they were having trouble finding a primary doctor that accepts Medicare in another part of the state. Is the AMA at war with the government over the lack of acceptable compensation? That's what it sounds like to me.


Well, Medicare is government and periodically the government sets up ALL the amounts of compensation for ALL types of government medical coverage, so after that is done, no other decision is possible...until the next time the gov has to set them again. Doctors can accept Medicare or not. If you accept Medicare, you accept the amount of compensation that it offers as payment in full.
Old -? For you....does it need to be a psychiatrist? Could you see a MSW, psychologist or other licensed mental health professional instead? If so, I'd suggest you contact Area on aging to see what mental health community based clinics are available and schedule an appt there.

If this is more about needing a psych as their an MD & you need a script done, that's more sticky. Child psych are in short supply as well & for kids on the ADD meds, there aren't enough child psych in practice. So parents often do both a pediatric visit AND a pediatric cardiologist visit to get the meds as the ped
....as the pediatric Cardio guy does the work up & clearance for heart so their regular pediatrician can write the RX for Adderal. It's cumbersome but a way around dealing with the limited # of psych in general practice & get RX.

Many small clinics are not fond of Medicare because of the billing nightmare and length of time in getting paid. In fact, I know of a rural clinic who decided to just GIVE away the seasonal flu shots to seniors because it took so much staff time to do the billing it was a financial loss.....so just decided it was a public service to give the vaccine for free.
I don't know if it has to be a psychiatrist or not. I definitely don't want to pay out of pocket for everything, so hopefully somebody accepts my health coverage. I vaguely remember a long time ago for a brief time seeing someone who wasn't a psychiatrist for depression. I think they had an actual MD overseeing them and that's the one who actually wrote the prescription for me. My DH sees a psych doctor at the VA, who treats him for PTSD and depression.
I had a hard time finding a gynecologist who accepted Medicare. I hadn't been to my old one in 5 years so they considered me a new patient. During that time I turned 65 and went on Medicare. She told me they weren't accepting new Medicare patients. Talk about frustrating.

Medicare was also not accepted by a Chiropractor I wanted to try for my neck and back pain. I paid for the visit because I needed help.
It is my understanding that most doctors will take Medicare, but they limit how many patients they can have who are "Medicare"... thus if you want to get to see a certain doctor, you would need to wait until one of his/her Medicare patients leaves the practice. No doctor could survive with having just Medicare patients as Medicare doesn't pay the full fee to the doctor.

Now if you were seeing the doctor prior to going on Medicare, said doctor usually will continue with you after you go on Medicare.

oldandtiredLJW, yes, I also ran into a problem trying to find a psychiatrist who would take Medicare. Eventually I found a person who has their Masters in Clinical psychiatry who I am seeing now and I am so happy I found her... she's my age, and had gone through all the stress/issues of dealing with an elderly parents... whew... she really does understand :)

So try the talk therapy route... you might need to try a few therapist before you find one that clicks. Just remember, a therapist cannot prescribe medications. You would need to go to your primary doctor to get a prescription.
My best friend found out that the Medicare Advantage plans don't always have doctors in their service area either - a doctor she wanted to go to took "traditional Medicare" but didn't take her Medicare Advantage plan because it paid even less than traditional Medicare. The office person was very sorry, but said that the "extras" that are part of the advantage plans are paid for by lower payments to network doctors.
The gynecologist that said she accepted Medicare and is even on Medicare's physician's list let me drive over 20 miles to her office, fill out several questionnaires, then sit and wait for my appointment, turned me down. The receptionist said that the woman who made my appointment was confused. The doctor stopped seeing Medicare patients 6 months ago. She said they accepted some types of Medicare but not all of them. Of course, she couldn't tell me what types were accepted. I have traditional Medicare and a Medigap policy. I asked how much it would cost to just pay for a pap smear. She said since I have insurance they were required to file it so they couldn't take cash from me. I couldn't believe it.

You're almost forced to enroll in Medicare because if you don't and you need it later in life the government will punish you with higher premiums. Then they pay doctors so little that they won't take Medicare patients. I have always been able to see my doctor of choice but those days are gone. It's depressing. I guess I'll just wait until an ovary explodes and then go the hospital.
ChampVA used to be my primary medical coverage, but I'm pretty sure I was required to apply for Medicare when I became old enough...there was no choice given if I wanted to keep ChampVA at all. Now ChampVA is secondary, but that doesn't help. If I can't use Medicare for a doctor, I can't use ChampVA either. I feel like I'm a pawn in a game of chess...and I lose, no matter what! I DID read somewhere that some doctors don't want Medicare Advantage patients because it pays so little. I'll ask my daughter (who is a doctor) about all this when she gets back from her vacation. Maybe she can suggest something.

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