Physicians refusing Medicare Patients

[Tuckamore]

Hi All,

I don't often post but today my pain and frustrations are high. I had to share them. As many of you know I am spending six months in Florida. Thankfully I have found a good PMP although it took more time then I would have liked. He provided me with several names of PCP for my medical needs.

In January I became eligible for Medicare as I am on SSDI due to this horrid chronic pain. In my home state of WI that is not a huge issue. So today after weeks on not feeling well I decided I had not choice but to consult a PCP. I took the list that my PMP provided me. Well in this state the first questioned asked when you call to make an appointment is, "What is your insurance." When I respond, "Medicare with a supplement" I have been told by everyone on that list that they do not take Medicare patients.  WHAT??? When I ask if they had any suggestions I am told, "Just keep calling around."

I am fortunate to have always been insured.....and I pay dearly for the supplement. I am a responsible adult and know the value of medical insurance.  I can't find a physician that will take a sick patient because they don't have the "right insurance." My eyes have been opened. My parents have been on Medicare for years. I have never had this issue with this fact in WI. No physician has turned them away because they were on Medicare. Is it because my home state has a different philosophy on patient care...or is this state (FL) an exception? Is the refusal to see Medicare Patients happening across the USA with the exception of my area of WI?

I have finally gone to Medicare's Site to seek a physician's name that may see me. I am truly sick....and getting sicker. If this fails I will be forced to go to Urgent Care. The Urgent Cares I have found in this area will only take Medicare patients IF they PAY UP-FRONT. They won't even bill Medicare!  We discovered that when my husband had an Urgent Ear problem a few months ago. In my state you are not refused care based on your ability to pay....and you never have to pay up front....unless it's a co-pay and then they'll ask if you are able to pay all or at least part of the co-pay.

I am fuming!!! What's wrong with this system and is there any fixing it?

Sorry for venting. I had to let some of this steam off before I continue these calls. I don't want to display a bad attitude. Who would want to see an ornery disabled person??

Thanks for listening. :o)

Blessings,
~Tuck    

[squirtatious]

I am so very sorry for your difficulties!!!! This is one of the reasons I began my journey into alternative healing so I can treat myself and my family instead of seeking western medicine. I am in the process of learning several methods of healing. Its a shame when a developed country such as ours has an under developed health care system!!! Time to get back to our earthly roots and utilize the old ways of healing. Mother earth provides us with all the natural resources to heal with...just have to reconnect with her healing abilities. I wis you the best, along with everyone else finding themselves in similiar shoes!!!! *hugs*

[Tuckamore]

Just an update. This is what I found out after hours of calling. Medicare patients in this area are seen in the local county building under a county health care system. No Private Clinic will see Medicare Patients!

Apparently they have rotating doctors that "volunteer" to take the amount of money that Medicare will pay for Physician's Visits. This is the same clinic that uninsured or Medicaid patients are seen. The COUNTY CLINIC!!  

Please don't get me wrong. I am no better and no worse then the next person. I am not above going to the county clinic. There is no shame in being poor.....but I am NOT poor. My insurance just happens to be Medicare....with a darn good supplement. You're correct Geminigirl. I almost forgot I also pay for Medicare, comes right out of my check. That means with what I pay for my Supplements and Medicare is OVER $425.00 a month! My goodness how do ppl do this that have to live only on a small SS Check or in my case an SSDI check?

So this morning I am going to the County Clinic. I will hold my head up high. I'm sure, like many of them I've worked my entire life....the last 18-20 years against doctors advice!! Often I even worked two jobs. I held good salaried, professional positions. I wouldn't give up, or give in to my pain. Those 20 years made a big difference in my SSDI check but any advantage I received from that has been eaten up in health insurance costs. .....and I STILL can't get a private doctor to see me!!!  SAD! Very Sad!  Here it doesn't matter if I have insurance/supplements or not....I will the same as the uninsured!

I'll let you know how it goes!

[mellie4]

So sorry you're running into this problem.  I'm not sure if private physicians here (in Massachusetts) can deny care based on the insurance.  I suppose they can.  On my worker's comp, my surgeon accepts my WC for my hand surgeries and the pain clinic as well, though I know it's at a much reduced rate.  A friend from work who is also out with a hand injury but lives  in a different area has had a very difficult time trying to find a doctor that will cover her through worker's comp.  

I do know you can't be refused care at a hospital due to an inability to pay.  So I guess your option then is for any little or big thing you go to the ER and then pay it off a little at at a time or declare bankruptcy.  

At the moment, the only insurance I have is my worker's comp, which only covers my hand.  My ex had carried our insurance, got fired, never signed up for the COBRA plan, never told me and I found out nearly a year later when I received a mountain of medical bills (both boys had been seen in the ER and had CAT scans, x-rays, orthopedic consults, etc.  I'm trying to pay a little off at a time.

Since I'm still technically an employee of the state, I am going to see if I can get us back on our insurance at the open enrollment we have in May.  Hopefully I can come up with a bit of money to pay the monthly premium (it's really high) and I'm just getting by on the worker's comp income as it is.

I'm not sure what the answer is but there has to be a better way!

[lupiemomof2]

I am blessed to have insurance thru my spouse as I am also on SSDI for SLE and qualified for Medicare.I opted out of the program from the getgo(unfortunately they had approved,backpaid,and insurance enrolled and billed me b4 I got the paperwork for approval).

i opted out because NONE of my drs take medicare except my rheumy(signs up at all offices)they bill your primary first,and I would have had to pay over 100 a month for 1 dr who bills me a 40 copay.The 100 was not including drug coverage.

Medicare is horrible-I dont know about payment/billing/insurance but to simply deal with.It took me 9 MONTHS to get unenrolled-never used the insurance and get my money back-after I had sent in forms from get go to NOT be enrolled(they never got them or any correspondence-no record of calls,etc.)I finally had to go thru local SSA office,write a certified letter and even then they told me I wouldnt get all the money back because I had waited to long to decide I didnt want it(not true)-I had an awful time trying to get away from the program and get my money back. I cant imagine trying to deal with them to find drs that want to take the insurance-I have heard thru receptionists they are hard to bill,take forever to pay,and deny procedures and treatments that drs deem necessary to perform and then the drs get stuck eating the charges they tried to bill or taking 4ever to get paid for services that medicare deems ok.

Good luck tuck I wish you alot of it.

[cocochennel]

Is this something we cld put a class action lawesuit against those dr's refusing to see us ssd people I think someone needs to stand up for our rights as we are people in need of healthcare if not moreso bc of our disability, who gave those drs the right to treat us as 2nd class citizens.?

[geminigirl1963]

Unfortunately, you're not alone in your situation with the healthcare system.  I also am on SSDI and have Medicare.  I'm fotunate that my PCP has always accepted Medicare and continues to do so, however, the rheuamtologist that I was seeing no longer accepts it so I had to stop seeing her.  I simply cannot afford to pay out of pocket for her.

My mother also has the same problem as you.  She's always been very healthy and actually is not all that confident in the medical field, so she has never really had a PCP - at least not since they moved here over 15 years ago.  She now is unable to find a PCP who will accept her because of her Medicare.  Even my dad's doctor - who treats him, who is also on Medicare (they still married and have the exact same insurance) - will not take new patients with Medicare.  So, like you and your husband, if my mom needs a doctor, she is basically forced to either go to an Urgent Care faciility or the ER.
No wonder our country and healhcare situation are financial trouble - it most certainly is not more inexpensive for insurance of any kind to pay for an ER or urgent care visit than it would be for an office visit!

The other sad thing is that we are being treated as if Medicare coverage is simply GIVEN to us at no cost to us.  We pay for Medicare, the same as anyone pays for insurance coverage - with monthly premiums and copays.

I've also very often run into the same thing you did when calling aroudn to doctors.  it used to be the first question they asked was "what are your symptoms or what is wrong", but now, the first question is always "what insurance do you have"?  Pretty bad when your type of insurance supercedes teh hypocratic oath!

I hope you get to feeling better Tuck!