Does My Doctor Accept Medicare?

When you are enrolling in Medicare for the first time or changing your Medicare coverage, it is advisable to check and ensure that any providers you wish to continue seeing will still be covered. How do you find out if your doctor accepts your Medicare coverage? The answer is quite simple. However, it does depend on the type of Medicare coverage you are enrolled in.

Are you enrolled in Original Medicare (with or without a Medicare Supplement)? If so, you will need to find out if your provider takes Original Medicare. Your Medicare Supplement will also cover any provider who takes Medicare. If you are enrolled in a Medicare Advantage plan, you will need to find out which providers are in your plan’s specific network.

How Do I Know if My Doctor Accepts Original Medicare?

Finding out if a doctor or provider takes Original Medicare is simple. You can visit medicare.gov and use their easy-to-use, free tool to find and compare providers and facilities that accept Original Medicare.

Along with finding providers, you can also use this tool to compare providers and facilities with information including:

• Cost estimates for doctors
• Dialysis facilities and hospitals in your area
• Contact information for local inpatient rehabilitation centers
• Quality ratings for home health agencies and nursing homes

You can also easily create a list of your favorite providers with this tool once you are logged in to Medicare.gov.

 How Do I Know if My Doctor Accepts My Medicare Advantage Plan?

All Medicare Advantage plans, whether HMO, PPO, or SNP, will have a provider network. This process may be familiar to you if you have ever had job-based coverage through a spouse, parent, or partner.

To find out which providers are in your plan’s network, you can go to your Medicare Advantage (Part C) plan’s website or contact your provider to request a provider directory. For some plans, you may need a referral from your primary care provider in order to have care from a specialist or specific hospital. It’s important to know that with some plans, choosing your primary care provider can also mean you are choosing a network of hospitals and specialists associated with them. These are all things to keep in mind when choosing a Medicare Advantage plan.

At any time during the year, Medicare Advantage plans can add or remove providers from their network.

If you have any questions, feel free to reach out to the team at Seniorstar Insurance Group at 732 658 5100.