When Physicians Stop Taking Insurance

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    Private health insurance used to be the ticket to a doctorís appointment. But thatís no longer the case in some affluent metropolitan enclaves, where many physicians no longer accept insurance and require upfront payment from patients ó cash, checks and credit cards accepted.

    On Manhattanís Upper East Side, itís not unusual for a pregnant woman to pay $13,000 out of pocket in advance for childbirth and prenatal care to a physician who does not participate in any health plan. Some gynecologists are charging $650 for an annual checkup. And for pediatricians who shun insurance, parents on the Upper East Side are shelling out $150 to $250 whenever a child falls or runs a high fever.

    http://well.blogs.nytimes.com/2012/1...ing-insurance/
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  4. 10 Comments so far...

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    I see a specialist who does not accept insurance. Well, he will file a claim for you, but you must pay out-of-pocket at the time of the visit and then hopefully you get a refund check from the insurer at some point for a portion of the charge. It has opened up a world of new treatment for me. Yes, it is expensive, but he is not constrained by the cost-cutting (and treatment-limiting) rules laid down by the insurer. If I weren't in a desperate situation (seen many of the specialists in my state, and have eventually become "too difficult" for them to treat because my condition is so bad) I would go with someone in-network. I can't imagine doing this with a family practice doctor or pediatrician, but in my case it has made all the difference.
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    Quote from DoGoodThenGo
    Private health insurance used to be the ticket to a doctorís appointment. But thatís no longer the case in some affluent metropolitan enclaves, where many physicians no longer accept insurance and require upfront payment from patients ó cash, checks and credit cards accepted.

    On Manhattanís Upper East Side, itís not unusual for a pregnant woman to pay $13,000 out of pocket in advance for childbirth and prenatal care to a physician who does not participate in any health plan. Some gynecologists are charging $650 for an annual checkup. And for pediatricians who shun insurance, parents on the Upper East Side are shelling out $150 to $250 whenever a child falls or runs a high fever.

    http://well.blogs.nytimes.com/2012/1...ing-insurance/
    Have had the same NYC doctor for >15 years now and he has never accepted insurance and or Medicare.

    Patients pay per visit and paperwork is provided to submitt for insurance purposes if requested/needed. He also does not do "billing" either, so either bring a checkbook, cash, or debit/credit card.
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    I wonder if the doctors who will not accept patients with medicare have forgotten that Medicare funded their training while in residency. I also wonder if these cash-only doctors will be able to treat their patients in teaching hospitals with medicare funded residents as part of their team.
    Not_A_Hat_Person and elkpark like this.
  8. 0
    Quote from Anxious Patient
    I wonder if the doctors who will not accept patients with medicare have forgotten that Medicare funded their training while in residency. I also wonder if these cash-only doctors will be able to treat their patients in teaching hospitals with medicare funded residents as part of their team.
    Yes, at least in NYC there isn't anything stopping them. However you'd be surprised how many NYC physicans neither have nor want hospital admitting rights. My GP hasn't had them in ages and says flat out he doesn't want them again either. By the way he teaches at a well respected and world famous NY medical school as well as having published tons of books, papers, research, etc...
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    My dermatologist will bill Medicare, but no an insurance company.
    Before I was 65 I was given a copy of the bill on a Medicare form. I paid the day of treatment, sent the bill to my insurance company, and eventually received a check for the amount the company determined was appropriate for out of network care.
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    It's called concierge medicine....we actually have physicians that charge a flat fee. Like 25K to 50K per year! This covers all visits and ensures that the physician treats them like gold!
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    I'm in California, and I asked my doctor (not concierge) that if a doc doesn't accept medicare, can a patient bill medicare directly. He said no, only doctors can bill. Which for me, means that my second insurance is also useless because they only pay if medicare is used first.

    Some doctors won't go concierge because their patient base are elderly. My oncologist says most of his patients are over 50, and there's no way they can afford cash only chemo. One session is billed at almost $20,000. Not that they get that much, but several thousand, I'm sure.

    I think it will pay for everybody to exercise, eat right and look both ways before crossing the street. To avoid ending up in the poorhouse. Interesting times ahead.

    Maisy, does that flat fee cover labs, radiology and other tests?
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    Quote from Anxious Patient
    I wonder if the doctors who will not accept patients with medicare have forgotten that Medicare funded their training while in residency. I also wonder if these cash-only doctors will be able to treat their patients in teaching hospitals with medicare funded residents as part of their team.
    If I'm spending the money to see one of these physicians (which I personally am doing at this time), then the last thing I desire is to be subjected to residents, interns, and students. God forbid! If I've ever got a choice, I'm going to avoid a teaching hospital. I know I'm not the only patient that feels this way, too. So if my cash-only physician told me, "Gee, I hate to break it to you, but you can't be a living science lab for the guy that graduated last in his class from the medical school in the Caribbean" I'm not going to be disappointed.
  13. 0
    That makes total sense since that Physican who you see was never a student , resident, intern and never had to gain any experience to get where they are today.....oh wait. Do you feel the same way about nursing students?


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