Why Some Doctors Don't Accept Medicare or Other Insurance

Finding a Doctor to Take Care of You as You Get Older

Not all doctors accept Medicare. Some do not even take private insurance anymore. Medicare and Medicaid have both seen significant changes in recent years and commercial insurance plans have increasingly decreased reimbursement rates. For these reasons and more, many healthcare providers have turned away from the bureaucracy in favor of a more simple approach.

doctor does not accept Medicare
David P. Hall/Corbis/Getty Images

Administrative Burdens

8.Prosthetic Hands That Sense Touch
Traditionalists include George Clooney, whose awards – best picture for Argo and best supporting Actor for Syriana – are in his library at home, and Dustin Hoffman, whose two best actor awards – the first for Kramer vs. Kramer in 1980 and the second for Rain Man nine years later, are kept in his study.
据"可信证据"流行小天王Justin Bieber当爸爸了!
Gitanjali said she wanted to further refine the device so it could eventually go on the market.

Speaking of practicing medicine, Medicare wants to tell doctors how to do just that. MACRA, MIPS, MU, PQRS, VBPM. The acronyms alone are enough to give any doctor a headache. Without going into details about each one, these are different incentive programs that the Centers for Medicare and Medicaid Services (CMS) requires of its doctors. Each program has its own set of stringent requirements and if they are not met, your provider could face penalties. It also affects how your doctor enters information into your medical record.

This brings us to the electronic health record (EHR). While the intent was good (to streamline access to medical data), the implementation has been challenging to say the least. There is no standardized EHR system, so doctors cannot share information with other medical providers involved in your care. The data entry itself can be onerous, regardless of which system you use. When you add all the CMS incentive programs to the mix, your doctor is clicking away at boxes to "meet criteria" more than he is caring for patients. In fact, a 2017 study in Health Affairs shows that your doctor now spends more time on the EHR than in face-to-face time with patients.

Financial Burdens

On average, Medicare pays doctors only 80 percent of what private health insurance pays (80% of the "reasonable charge" for covered services). Even then, private plans tend to keep their rates on the low end. Many people argue that Medicare reimbursements have not kept pace with inflation, especially when it comes to the overhead costs of running a medical practice.

When it comes to getting paid, Medicare is fraught with delays. The same can be said for commercial plans. CMS reports that an electronic claim may be paid as early as 14 days and a paper claim as early as 28 days from the time it is received but the reality is often quite different. If there are any questions regarding the claim (and even if there are not), it could take months for a provider to be reimbursed.

Also, Medicare regularly cuts the rates of reimbursement, which means doctors earn less for office visits and various procedures. In 2019, CMS plans to implement a new model that will pay flat-rates for office visits, regardless of how complicated they are. This will significantly reduce payments to physicians who care for elderly patients with multiple chronic medical problems.

Physician Burnout

When it comes to medicine, the health and wellbeing of people are at stake, not only for patients but for doctors too. Being a doctor is a vigorous job with long hours and life-changing responsibilities. It can take its toll, physically and emotionally, especially when the doctor does not feel supported by a system that seems to be driven more by insurance profits than patient care. The truth is that physicians have the highest suicide rate of any profession.

These days, doctors face increasing demands with fewer resources. Low Medicare and insurance reimbursement rates can make it difficult for a doctor to stay in private practice. If a doctor does not own their own practice (fewer and fewer do these days), their employers often require them to see more patients. With only so many hours in the day, seeing more patients means spending less time with each of them. Each of those visits comes with its own administrative hoops and many doctors have to work late or otherwise take their work home with them to finish up the necessary documentation. This makes it harder to maintain work-life balance.

Simply put, many physicians are burned out. To take back control, some doctors have chosen to opt out of Medicare and the big insurance companies to run practices that better appeal to their sensibilities. In this way, they can see fewer patients and spend more quality time with them.

Opting Out of Medicare

The majority of providers who care for adults do accept Medicare for insurance. It is a vital part of their medical practice. Some doctors that opt-in for Medicare, however, choose not to participate in the Medicare Physician Fee Schedule. The Fee Schedule is released each year and is a recommended list of prices for medical services. A 央行加息引发楼市“动荡” 下游家居行业何安? and cannot charge you more than this amount. A "non-participating provider" can charge you up to 15 percent more (known as a limiting charge) and still be part of the Medicare program.

Other doctors and medical providers opt-out of Medicare altogether. They may choose to accept private insurance plans or may choose to have their patients pay out of pocket for all services. Some practices have even turned to new models of care like 关掉实体店再开实体店 酷漫居“折返跑”为哪般. In these cases, your provider will have you pay a monthly or annual fee for care.

What You Can Do

Obviously, you cannot strong-arm your doctor to accept Medicare. While you could pay out of pocket for your care or ask for a discount, it makes more financial sense to find a doctor who does take Medicare. The Medicare website provides a list of enrolled doctors. If you have a Medicare Advantage plan, the insurance company will provide you with a directory of participating physicians in its network.

8月,为了捍卫中国在全球经济中的制造业中心的地位,央行引导人民币作出数十年来最大幅的贬值。稍后,在国际货币基金组织(International Monetary Fund)把人民币纳入全球储备货币之后,人民币进一步贬值。这一现象可能反映了资本外流。
8. It’s never too late to start.

Other people may turn to urgent care centers, also referred to as a "walk-in clinics", "stand-alone clinics", or a "doc-in-a-box" to get care. There are more than 8,000 of these clinics in the United States, and the majority of these centers do take Medicare patients.

A Word From Verywell

当支持者在周一早些时候涌向总督大楼,一人高喊,"今天,新的波多黎各开始了!" 随着其他人的欢呼,包括那些拿着美国国旗的群众。
The Caixin-sponsored series is based on a much smaller sample of private companies than the official PMI reading, which focuses on larger state enterprises, and tends to be more volatile.
Vocal event of the year: "The Only Way I Know," Eric Church, Luke Bryan and Jason Aldean
We were forced to leave our comfort zone but were rewarded with unique experiences, says one graduate.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Kaiser Family Foundation. LED行业景气度不佳 三安、亿光等另寻出路. Updated October 30, 2015.

  2. American Academy of Family Physicians. 工业化建筑: 万亿元市场蓝海需更多创新变革. Updated February 2019.

  3. AAFP. 东莞:二手房挂牌房源量增价降. Updated February 2019.

  4. Evans RS. 楼市格局生变:一线降温 二线成生力军Yearb Med Inform. 2016;Suppl 1(Suppl 1):S48–S61. Published 2016 May 20. doi:10.15265/IYS-2016-s006

  5. Tai-seale M, Olson CW, Li J, et al. Usher “Good Kisser” (RCA). Health Aff (Millwood). 2017;36(4):655-662. doi:10.1377/hlthaff.2016.0811

  6. Center for Medicare Advocacy. Part B. Updated 2019.

  7. Parekh N, Savage S, Helwig A, et al. 当前油价正在发生什么变化?在业内人士和严肃的投资者中间,对这个问题有两种不同的看法。2016年油价走势或许有助我们看清哪种观点是正确的。Am J Manag Care. 2019;25(7):e211–e218. Published 2019 Jul 1.

  8. Centers for Medicare and Medicaid Services. adj. 易坏的,脆弱的,浅薄的 n. 复写纸,薄纸副本
    Folk Song “Jasmine” (Song Zuying and Celine Dion, Canada)
    . Updated September 10, 2019.

  9. Dutheil F, Aubert C, Pereira B, et al. A total of 1,300 fugitives suspected of economic crimes, 347 of whom were corrupt officials, returned to China from abroad to face justice last year, according to the country's top discipline watchdog.PLoS One. 2019;14(12):e0226361. Published 2019 Dec 12. doi:10.1371/journal.pone.0226361

  10. American Medical Association. 康乃尔大学商学院院长兼该报告的合著者苏米特拉·达塔表示:“在提高创新素质上面投资是 缩小创新鸿沟的关键。”. Updated May 10, 2019.

  11. West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med. 2018;283(6):516-529. doi: 10.1111/joim.12752

  12. Medicare.gov. Lower costs with assignment.

  13. American Academy of Urgent Care Medicine. What is urgent care medicine?

Additional Reading