by Russell Noga | Updated June 21st, 2023
Medicare Supplement (Medigap) plans are a popular choice for those who are enrolled in Medicare and want to cover the out-of-pocket expenses that Original Medicare does not cover.
However, not all doctors accept Medicare Supplement plans. This is likely because they do not accept Medicare Part B, and a supplement does just what it states. It supplements some, or all, of the costs not covered under Medicare Part A and B.
It is essential for individuals to understand the acceptance of these plans by physicians and how it affects their healthcare coverage.
Who Accepts Medicare Supplement Plans?
For a doctor to accept a Medigap plan they must first accept Original Medicare Part A and B.
Most will accept your Medigap plan if they are contracted with Medicare. The acceptance of Medicare Supplement plans depends on several factors, including the physician’s specialty, location, and type of practice.
Most physicians accept Medicare Supplement plans, but there are some who choose not to participate in Medicare. The good news is we provide easy resources and tips to find a doctor that will accept your plan.
Factors Affecting Acceptance of Medicare and Medigap Insurance
There are several factors that influence a physician’s decision to accept Medicare and Medicare Supplement plans, including:
- Reimbursement Rates: One of the major factors affecting the acceptance of Medicare Supplement plans is the reimbursement rates offered by these plans. If the reimbursement rates are low, physicians may choose not to participate in these plans.
- Network Participation: Physicians who are in a Medicare Advantage plan network are more likely to accept Medicare Supplement plans.
- Specialty: The specialty of the physician can also affect the acceptance of these plans. For example, some specialties, such as cardiology and oncology, may have higher out-of-pocket costs and require more specialized care, leading to a higher likelihood of acceptance of Medicare Supplement plans.
- Type of Practice: The type of practice, whether it is a solo practice or a group practice, can also affect the acceptance of Medicare Supplement plans. Group practices are more likely to accept these plans as they have a larger patient base and can negotiate better reimbursement rates.
How to Find Physicians Who Accept Original Medicare
There are several ways to find physicians who accept Medicare patients, including:
- Medicare’s Physician Compare Website: Medicare’s Physician Compare website allows individuals to search for physicians who accept Medicare Supplement plans by entering their zip code, specialty, and name.
- Contacting the provider’s office directly: Individuals can also contact the doctor they wish to see if they accept Medicare Part B
- Asking for Recommendations: Individuals can also ask for recommendations from friends, family, or other healthcare providers to find physicians who accept these plans.
In conclusion, it is essential for individuals to understand the acceptance of Medicare Supplement plans by physicians and your first step is to always ask if they accept Part B Medicare.
If they do then you can let them know you have a Medigap plan and make your appointment. It does not matter which company you have your Medicare Supplement plan with, they will accept all of them.
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Frequently Asked Questions (FAQs)
Do all doctors accept Medicare supplement plans?
No, not all doctors accept Medicare supplement plans but those who accept Original Medicare will. While many healthcare providers accept Medicare, you will simply need to make sure the doctor or sp; specialist that you see does.
Why don’t all doctors accept Medicare supplement plans?
Some doctors may choose not to accept Medicare supplement plans because they don’t accept Original Medicare. They might have reached their patient capacity or have specific billing preferences that don’t align with the requirements of Medicare. To be sure, contact the doctor’s office prior to your visit.
How can I find doctors who accept Medicare supplement plans in 2024?
To find doctors who accept Medicare supplement plans, you can refer to the Medicare website or simply call your doctor. There are no changes to Medicare Supplements in 2024 and doctors accepting them.
Can doctors choose which Medicare supplement insurance companies they accept?
No, they may not. If a doctor accepts Original Medicare then they will also accept your Medigap plan, regardless of which insurance company you have coverage with. They may not pick and choose which Medigap companies to accept.
Can doctors charge more for their services if they accept Medicare supplement plans?
Most doctors (Well over 90%) accept the approved amount from Medicare as full payment. However, doctors who choose not to accept the Medicare-assigned rates can charge additional fees for non-covered services or services beyond what Medicare typically covers. Medicare Supplement Plans F, and plan G cover these excess charges, though Medicare Plan N does not.
Do all specialists accept Medicare supplement plans?
If a specialist accepts Original Medicare they will accept your Medicare Supplement plan.
Find the Right Medicare Plan for You
Discovering the best Medicare plan shouldn’t have to be confusing. Whether it’s a Medigap plan, or you have questions about Medicare Advantage or Medicare Part D, we are here to help.
Call us today at 1-888-891-0229 and one of our knowledgeable, licensed insurance agents will be happy to assist you!
Russell Noga is the CEO of Medisupps.com, an online Medicare Agency and resource center helping Medicare beneficiaries learn about Medicare, Medigap and Part D drug plans, and Medicare Advantage plans since 2009. Russell is licensed in all 50 states and has been featured as a keynote speaker, and author of several publications, along with hosting the very popular Medisupps.com Youtube channel.