dornweg asked in Business & FinanceInsurance · 1 month ago

a question about medicare health insurance....if someone under medicare is wishing to see a doctor who does not accept medicare......?

is it possible to pay out of pocket for the doctors bill or is the doctor unable to accept the cash payment.....also, if that doctor finds something needing treatment, and suggests a certain great hospital, will medicare pay for THAT hospital?

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  • Anonymous
    1 month ago
    Favorite Answer

    The doctor's office WILL accept cash payments.  You are certainly free to ignore your "in network" doctor list and use a different doctor at your expense.

    The hospital MUST be in network for medicare to cover it.  Just like with doctors, if the hospital is not in the network of accepted providers, then YOU would have to cover all the expenses.  Medicare would pay for nothing.

    Also - consider this - even if the hospital is in network and your hospital expenses are covered  - you would still be paying for all DOCTOR expenses out of pocket.  

    Here is an example - you pay to go the doctor of your choice not covered by medicare and this doctor recommends a surgery.  The hospital the doctor wants to use is covered - so all surgery room expenses are covered and room expenses are covered if you need to stay - BUT - that DOCTOR is still going to bill you for doing the surgery - which could be thousands of dollars that would NOT be covered because that doctor is still NOT in network even if they are in a network covered hospital.

    You can certainly go to any doctor for an initial diagnosis and then get a second opinion if you want to.  But if it is an expensive medical need - you will need to stay with approved providers to get the most coverage from your medicare health care.

    • dornweg
      Lv 5
      1 month agoReport

      thank you....the hospital in my question is amazing, but you usually need doctors for access.

  • Erik
    Lv 7
    4 weeks ago

    Of course you can pay cash, but if it's major you wouldn't be able to afford it.

  • B
    Lv 7
    1 month ago

    you will be royally in trouble with a doc who does not accept medicare because further treatments and possibly tests and hospital bills won't be covered.

  • 1 month ago

    Many doctors will accept cash, however some have contracts that prevent them from accepting patients who are out of network.     Medicare will never pay for a hospital that doesn't accept Medicare.  See, Medicare has "set rates" which are generally pretty low.  They won't pay an increased amount for a different hospital, and the different hospital probably doesn't want to try to collect the difference from the patient. 

    • dornweg
      Lv 5
      1 month agoReport

      thanks for answering...I just wanted to know how people having medIcare can have access to the great hospitals if doctors dont have privileges, and the doctors that do refuse medicare patients.

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  • 1 month ago

    Do you have regular medicare or an advantage plan. With a regular supplemental plan, I've found 95% of the Drs accept that. If you have an advantage plan you have to stay in network for it to be covered, otherwise, of course you can always pay cash all Drs will gladly accept. I would try to find a Dr. that accepts your medicare plan.

    • dornweg
      Lv 5
      1 month agoReport

      thank you for answering.of all the choices I have always selected fee for service, never a doctor from network..privately, this was great, you just find a doc a good one and private insurance pays the bill..but many good docs refuse medicare, it is getting difficult to find that quality who accepts

  • 1 month ago

    Doctors will always accept cash.  

  • 1 month ago

    Doctors who do not accept Medicare patients will accept certain other insurance plans and they always accept cash. As for the hospital, you have to ask them if the hospital works with Medicare on the parts of treatment that are separate from the doctor. To avoid a possible mess and financial disaster, it's best to find a doctor that accepts Medicare.

  • Anonymous
    1 month ago

    The doctor's office will almost certainly take cash.

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