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What You Need to Know About Choosing a Certified Medicare Provider!

By June 26, 2022No Comments

What You Need to Know About Choosing a Certified Medicare Provider

For many seniors, choosing a doctor that accepts Medicare is one of the most important health care decisions you will ever make, so it’s important to find the right provider and to be careful about what you look for in that provider. Many new doctors are changing their practices to make them more efficient, resulting in lower costs and faster wait times; however, this can also affect their quality of care if they are not properly equipped to handle the rush of patients.

Compare different types of plans
Do you know your medicare plan from your medicare supplement? What about dual-eligible from basic drug coverage? With so many options to choose from, choosing a health insurance plan can be stressful. To help you make an informed decision about which type of plan is best for you, we’ve done some research and put together some helpful info. Compare your options below!

Look into out-of-pocket costs
Out-of-pocket costs refer to how much you will spend on services that are not covered by your insurance. Every plan is different, so it’s best to understand how much you will be required to pay up front before choosing a doctor or medical facility. This way, you can know ahead of time if you’re able to afford treatment in case something serious occurs.

Don’t neglect quality ratings
If you’re considering switching providers or if you want to make sure your doctor is in good standing, visit and check out your provider’s quality rating. Since 2006, medicare has rewarded or penalized health care providers based on their performance on certain clinical measures such as cancer screening rates and blood pressure control. These measures are intended to improve seniors’ health care experience and reduce costs over time by reducing preventable hospitalizations and emergency room visits.

Understand your own healthcare needs
Before choosing a provider, it’s essential to understand your own healthcare needs. Do you want someone who takes your insurance? How far from home are you willing to travel? Do you need emergency care or primary care only? Once you have an idea of what is important for you, it will be easier to sort through all of your options and find one that best suits your personal healthcare needs.

Budget for uncovered services
One of Medicare’s best-kept secrets is that you don’t have to do business with providers who accept assignment, meaning they accept Medicare’s rates as payment in full. Instead, you can get quotes from two or three doctors who may be able to provide identical services at lower prices. To cover uncovered services not covered by Medicare Part B, add an extra 3% onto your monthly premium for a Medigap plan F or H.

Research your options
Now that you’ve picked your health plan, it’s time to choose your provider. But with more than 500,000 certified providers nationwide and dozens of insurance companies available, how do you decide which one is best for you?

Talk with friends and family about their experiences
The Centers for Medicare and Medicaid Services (CMS) issues each provider with an overall rating that looks at medical excellence, patient safety, and cost-related measures. While it’s tempting to look only at overall ratings when choosing a doctor, you should take time to talk with friends and family about their experiences. They can help you understand how much a specific practice costs—and what services it offers.

Consider alternatives to traditional Medicare insurance
The official name for Medicare insurance is actually Medicare Advantage, and it refers to several alternative ways of getting your health care from private insurers instead of (or in addition to) traditional programs offered by federal agencies. These alternatives are sometimes called Medigap plans, because they cover part or all of what traditional Medicare doesn’t.

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