Do I Need A Doctor Before I Apply For Medicare?

With all the recent Medicare changes, patients wonder if they need to have a doctor before applying to the program. Since most doctors participate in Medicare, even with the ongoing Medicare changes, having a primary care physician before enrolling isn’t necessary. In fact, applying for Medicare should be a patient’s first priority.

Notifying Medicare

Medicare doesn’t require registration with a doctor. Once enrolled in the program, the patient should find a doctor to his or her liking. Before making the first appointment, the patient should ask if the doctor participates in Medicare. If yes, the doctor will file claims directly to Medicare for reimbursement. The patient only needs to receive services, the doctor’s office will do the rest.

Establishing a patient-doctor relationship

Recent Medicare changes cover a variety of preventative and one-time services that the doctor reports to Medicare on the patient’s behalf. One benefit is the “Welcome to Medicare” physical exam. This is a complete evaluation of the patient’s current health status, to establish a baseline for patients new to the Medicare program so that a doctor can determine future medical needs. Patients should notify their doctor that they are newly enrolled in Medicare to receive this one-time service after they are covered. The doctor’s office will submit a claim with the appropriate coding according to current Medicare changes.

Using Medicare is easy

Once a patient has applied for Medicare and been enrolled, he or she can use any doctor, even if the doctor doesn’t participate. Out-of-pocket expenses will be somewhat more for doctors who don’t participate, but all doctors are required by law to accept set fees for covered services provided to Medicare patients. Medicare changes are affecting health care nationwide. Applying is the first step, locating a doctor is secondary.

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