As a former hospital CEO, with many colleagues at nearby hospitals, I had quick access to the best medical care.
Now, as a Medicare enrollee, I am finding it more and more difficult and time-consuming to find doctors who will take Medicare. And, of course, I don’t want to sacrifice quality for price.
When a physician opts out of Medicare, ”The physician must sign and file an affidavit agreeing to forgo receiving any payment from Medicare for items or services provided to any Medicare beneficiary for the following 2-year period…”
Most significantly, if getting care from an opted-out physician the beneficiary (me or any other Medicare enrollee): “gives up all Medicare payment for services furnished by the “opt out” physician; agrees not to bill Medicare or ask the physician to bill Medicare; is liable for all of the physician’s charges, without any Medicare balance billing limits; acknowledges that Medigap or any other supplemental insurance will not pay toward the services; and acknowledges that he or she has the right to receive services from physicians for whom Medicare coverage and payment would be available. http://www.aafp.org/practice-management/regulatory/medicare.html
I have paid into Medicare for 45 years and, like many of you, now or later, don’t want to pay full out-of-pocket charges where doctors have opted out of Medicare. Why pay life-time premiums for Medicare than get care from non-Medicare providers.
One can inadvertently wind up with a big bill even when vigilant. For example:
– Go to an Emergency Room where the hospital takes Medicare but the ER group does not. http://www.cbs5az.com/story/23063821/emergency-room-doctors-may-not-take-insurance-even-if-hospital-does
– Your primary care physician takes Medicare but refers you to specialists who don’t.
– When you are admitted to the hospital for surgery and the surgeons takes Medicare and the anesthesiologist which you had no say in selecting (and perhaps radiologist and pathologist) does not.
– And when the surgeon is assisted by another surgeon, which you were not told about, who does not take Medicare.
– You assume your MediGap insurance will cover an expense because like I was, you aren’t aware that MediGap insurance only clicks in for Medicare approved care.
Now blaming it on Obamacare and perhaps in anticipation of Trump/ Ryan Care, the Minneapolis Star Tribune, in an article by Jeremy Olson reported that:
“Mayo Clinic’s chief executive made a startling announcement in a recent speech to employees: The Rochester-based health system will give preference to patients with private insurance over those with lower-paying Medicaid or Medicare coverage, if they seek care at the same time and have comparable conditions.
“Mayo will always take patients, regardless of payer source, when it has medical expertise that they can’t find elsewhere, said Dr. John Noseworthy, Mayo’s CEO. But when two patients are referred with equivalent conditions, he said the health system should “prioritize” those with private insurance.”
Let’s make sure that access to Medicare is not further compromised by health care providers.
“DHS questions whether Mayo policy violates law”
Recent reports say that Mayo Clinic will give preference to privately insured patients under a new policy, which is under scrutiny by the DHS.
The Minnesota Department of Human Services is probing the Mayo Clinic for possible violations of civil- and human-rights laws by putting a higher priority on patients with commercial insurance.