Will my doctor or hospital accept my Medicare Supplement Plan?
If a doctor accepts Medicare which is your Primary coverage, they will accept your Medicare Supplement plan (also known as Medigap), regardless of the type of Medigap plan you’re enrolled in. If you aren’t familiar with what a Medicare supplement plan is, once you turn 65 and sign up for Medicare, you have a choice of any Medicare supplement plan that is available in your state. This would be regardless of any health conditions. Medicare supplement insurance covers the remaining costs you are responsible for after original Medicare pays its portion, such as Medicare deductibles, coinsurance costs, skilled nursing facility costs after Medicare runs out and hospital costs after the Medicare-covered days are over. In other words, you pay your Medicare supplement plan premium and then the policy pays your expenses under Medicare. These Medicare Supplement Plans “gap” the differences, so your out-of-pocket expenses are reduced or eliminated.
Can I use any Doctor or Hospital with a Medicare Supplement Plan?
When you buy a Medicare supplement insurance policy, you keep your original Medicare and can go to any doctor who accepts Medicare. Your Medicare supplement insurance works in tandem with your Medicare, so if your doctor accepts Medicare, your supplement insurance is accepted as well. Be sure your doctor accepts Medicare when you make your appointment to avoid any denial of payment later. Studies show that most doctors do accept Medicare, although those taking on new patients has dwindled. This can make it more difficult to find a doctor once you are enrolled in Medicare.
Why Won’t a Doctor Accept a Medicare Supplement Plan?
If a doctor won’t accept a Medicare Supplement Plan, it is most likely due to the person mistakenly referring to their Medicare Advantage plan as a Medicare Supplement plan. Medicare Advantage Plans have their own networks and are usually PPOs or HMOs. These networks change annually, sometimes in the middle of the year. If you’re on a Medicare Advantage plan and your doctor won’t accept it, they might not be in your network anymore.
By Joe DeAngelis
Medicare Supplement Advisory services