Mecicare question? for anyone young on medicare. ?

Question

I would like to know if anyone out there has or is dealing with Medicare. To find a physician, surgeon and hospital who all take medicare seems to be a nightmare. When i call to find out if they take medicare they say YES but when I look up the physician name he is not listed nor is part of the hospital (another building). So do I presume I will not be charged for the physicain fee or the sureons fees or even the hospital building. Also some hospitals are listed but not the physcians and they still say they take medcare. Can anyone tell me how this works. I have called Medicare several times and have gotten conflicting information with if they say YES hten they do, and maybe our database is not up to date. I am very very confused and concerned b/c I cannot afford at all to pay any fees in full for anything.

So it seem either the hospital is on their list but not the physician or surgeion or the other way around. Should I just presume if they tell me YES than i am OK. I know many may be confusing me when they say they bill medicare for me they just think YES we send in the bill for your behalf which is not hte same hting as the servies being covered. I mean do you take Medicare assignments but b/c they are not listed it really makes me nervous or am I being ridiculoous in thinking why would a hospital lie about taking medicare for hospitals and physicians or are they just thinking i am asking do you physically just do the billing for me and hten I will be denied coverage etc.......? Does anyone know as I seem to not get direct answers about participation from both Medicare and the hospitals and their input about their physicians ror do I keep searching the database to find a hospital and find a physican and surgeon etc. Would that be the best thing to do even if you have a preference b/c of certain conditions there are better dr/s and hospital more experienced, or does everyone take Medicare that says so cos no-one really turns medicare away. I do know that if you pick a surgeon who does not take Medicare then htey do not cover anything , the OR, bed, room, pathology, tests, meds, anastethilogy , [pathology etc. I would really appreciate it if anyone out there deals with Medicare and has run into this or not or can tell me how this works b/c I just am not getting straingt answers from anyone they all seemed confused or are not listed on the medicare.gov site.---help--------------lexie

Answer 1

I understand what you mean because health problems are hard and finding a surgeon is even harder. In my experience find the surgeon first and make sure he/she accepts medicare. Most doctors that accept medicare work through hospitals that do as well. I say choose the doctor first because a hospital that doesn't accept medicare will let you know up front but the surgeon may not know or will not advise until later. In addition the surgeon's bill is way higher than the hospital bill so if there was a mix up with the hospital you would be paying the lesser half.  Surgeons bill separately from the hospital so it is possible that the hospital accepts medicare and the surgeon doesn't. It is less likely to be the other way around.  If you pick a surgeon that doesn't accept medicare you will have to pay the expenses , If you pick a hospital that doesn't accept medicare you will have to pay the hospital expenses also. I just wanted to reinirate that the doctor's bill is seperate from the hospital bill they work in the hospital but not for the hospital . You could consider them independant contractor's. This has happened in recent years because hospitals don't want to be liable for malpractice of the associated doctors.

Answer 2

if they say yes then yes they take it, as for the confusion of the hospital saying yes but the doctor not being listed what it usually is the hospital pays the doctor, so the doctor takes what ever the hospital takes

Answer 3

it may depend on the state you live in but where im at you have to chose an hmo to be a part of and that hmo is connected to a specific hospital system and any doctor or services you use at that hospital are covered, i very rarely have co pays except for prescriptions, which are minimal, but as long as its at that hospital i can see specialists and everything is always covered

Answer 4

       No matter if they accept Medicare, you still have to pay 20% of the bill.  As for Medicare not knowing if the doctor or hospital accepts Medicare, that is typical of a government agency.  Their information is always way behind reality.  When you call a doctor or hospital and ask if they accept Medicare, when they say yes, it means they accept the Medicare payment, not that they just bill to them.  If you have doubts, then when you go to that facility for services, ask again before anyone treats you for anything.  That way you can be sure.