robi
Frequent Contributor (1K+ posts)
Member # 5547
posted
If a person is on medicare and a particular doc does not take medicare then can that person still see that doc if they are willing to pay out of pocket?
I heard if a doc doesn't accept Medicare then s/he is prohibited from seeing folks that have Medicare.
-------------------- Now, since I put reality on the back burner, my days are jam-packed and fun-filled. ..........lily tomlin as 'trudy' Posts: 2503 | From here | Registered: Apr 2004
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lymednva
Frequent Contributor (1K+ posts)
Member # 9098
posted
I'vie never heard that, but couldn't say for sure. I'm sure someone will come along who has dealt with that before and fill you in.
-------------------- Lymednva Posts: 2407 | From over the river and through the woods | Registered: Apr 2006
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cantgiveupyet
Frequent Contributor (1K+ posts)
Member # 8165
posted
ive heard of one llmd like this, they wont let you see them if you have medicare.
but i see a llmd that doesnt take medicare, i cant submit claims to medicare or my scecondary, so i just pay out of pocket.
Labs so far have been covered, but im not sure if that is true for all dr who dont take medicare.
-------------------- "Say it straight simple and with a smile."
"Thus the task is, not so much to see what no one has seen yet, But to think what nobody has thought yet, About what everybody sees."
-Schopenhauer
pos babs, bart, igenex WB igm/igg Posts: 3156 | From Lyme limbo | Registered: Oct 2005
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posted
i have a faint recollection of a doctor in dc/md area saying she couldn't see medicare patients because she was trying to reclassify herself insurance-wise? almost like a temporary (like two-year) blackout. i have no idea why or if i am even remembering this correctly.
Posts: 52 | From Atlanta, Ga | Registered: Jun 2007
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lymebytes
Frequent Contributor (1K+ posts)
Member # 11830
posted
It is baloney...but this can be tricky under the following circumstance. I will give you an example I ran into.
My LLMD works at an office where they do not accept any insurance. BUT he also works part time at a hospital and he is part of medicare there at the hospital, which means he has to accept medicare everywhere even at the office.
Since the office prohibits him accepting medicare, when I go to see him in person I have to see another LLMD in the office. I can however do phone consults w/him because medicare will not cover phone consults with any doctor. I could also see him for IV vitamins etc., anything Medicare would't normally cover I can see or talk to him about in person and pay cash.
If the doctor is does not accept Medicare and you have Medicare then you can pay out of pocket to see him. Medicare doesn't care who you see and what doctor you give your cash to, as long as you understand they won't reimburse you for Md's who have opted out or do not belong, don't even bother submitting claims for Md's that are not in their insurance network, they will be denied.
All labs and prescriptions he orders are covered, oddly enough.
If your doctor is not part of Meidcare, there is no reason they cannot take you on a cash basis, none. In fact Igenex accepts medicare and bills them directly - not any other insurance will Igenex do this.
I have seen 2 LLMD's one an ILADS LLMD and he does not belong to Medicare or any other insurance...we all pay cash, that simple.
sixgoofykids
Honored Contributor (10K+ posts)
Member # 11141
posted
I think the easiest thing to do is call the doctor you are thinking of seeing and ask. Sorry, I know nothing about it. My LLMD is 100% out of pocket.
-------------------- sixgoofykids.blogspot.com Posts: 13449 | From Ohio | Registered: Feb 2007
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robi
Frequent Contributor (1K+ posts)
Member # 5547
posted
Thanks for letting me klnow how this works. It makes more sense to have to pay out of pocket than not be able to see a certain doc at all.
Couldn't get by with out all of you.
robi
-------------------- Now, since I put reality on the back burner, my days are jam-packed and fun-filled. ..........lily tomlin as 'trudy' Posts: 2503 | From here | Registered: Apr 2004
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