Ashford Insurance

Tips for Medicare Beneficiaries and Smaller Medical Providers

Picture of Sonia Ashford

Sonia Ashford

Sonia Ashford is the owner of Ashford Insurance, an independent health insurance agency specializing in Texas Medicare insurance.

As the number of individuals eligible for Medicare continues to rise, some smaller medical providers are choosing to opt out of the program, presenting a potential challenge for Medicare beneficiaries who may need to seek new healthcare providers.

Several factors contribute to this trend, including the intricate and time-consuming paperwork associated with billing Medicare, as well as reimbursement rates that often fall below what providers can charge privately insured patients.

For Medicare beneficiaries finding themselves in this situation, there are several proactive steps to consider:

  1. Communication with Your Doctor:

    • Inquire whether your current doctor is willing to continue seeing you if you submit the bill to Medicare and await reimbursement. This option can allow you to maintain your existing doctor-patient relationship without the need to search for a new provider.
  2. Seeking Doctors Accepting Medicare Assignment:

    • Explore the possibility of finding a healthcare provider who accepts Medicare assignment. This means the doctor agrees to accept the Medicare-approved amount as full payment for covered services.
  3. Filing a Claim with Medicare:

    • If your doctor does not accept Medicare assignment, you might need to pay the full bill upfront and then file a claim with Medicare for reimbursement. Detailed information on how to file a claim can be found on the Medicare website.

While encountering a doctor who does not accept Medicare assignment presents potential challenges, it’s important to note that numerous excellent healthcare providers are still willing to accommodate Medicare patients. By conducting thorough research and asking pertinent questions, you can identify a doctor who aligns with your needs and financial considerations.

Additional Tips for Finding a Medicare-Accepting Doctor:

  • Medicare Provider Finder Tool:

    • Utilize the Medicare Provider Finder tool to search for doctors and healthcare providers in your local area who accept Medicare.
  • Seek Recommendations:

    • Consult with friends, family, and other healthcare providers for recommendations on doctors who accept Medicare.
  • Contact Your State’s Health Insurance Assistance Program (SHIP):

    • Connect with your state’s SHIP for assistance in identifying Medicare-accepting doctors in your region.

In conclusion, as changes in healthcare dynamics unfold, staying informed and proactive is key to ensuring continued access to quality medical care. If you have further questions or require additional assistance, please feel free to reach out. Wishing you optimal health and a seamless healthcare journey.




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Picture of Sonia Ashford

Sonia Ashford

Sonia Ashford, “The Medicare Insurance Lady”, has been helping Medicare eligibles in Texas with their Medicare Insurance since 2005.