Shalloway and Shalloway, P.A.

The Problem of MD’s Dropping Medicare and Some Suggested Solutions

MD holding medicare sign

Some medical doctors, especially internists such as gastroenterologists, gynecologist, psychiatrists, as well as some other medical specialties have stopped accepting new patients on Medicare.  One of the  reasons for is that they have dropped out of the insurance system. Other reasons include that they have stopped accepting new patients on Medicaid.   The reasons that doctors have expressed include that reimbursement rates are too low and the required government paperwork overwhelms their staffs for the amount of the payments. 

This trend is forming a perfect storm with another trend in healthcare.  There is a shortage of internists.  The American College Physicians estimates that the population of retired people in the year 2025 will be lacking 35,000 to 45,000 internists that will be needed. 

Strangely enough, some patients are going to doctors who no longer accept patients on Medicare.  These patients are signing private agreements with these doctors that stipulate that the patients will be responsible for payment of medical bills. 

Other patients of retirement age are using urgent care centers, walk-in treatment centers, which generally do accept Medicare. 

A more expensive option is concierge healthcare.  Concierge healthcare comes in two versions. Some doctors accept Medicare and the patient pays an annual retainer, as someone might do with an attorney.  This retainer may be in the range of $1,600 to $1,800 annually. 

The second form of concierge healthcare is doctors who have dropped out of the Medicare system.  In this type of concierge healthcare, the annual fees paid by the patient may go as high as $15,000 annually.

One of the options that have been proposed to extend the life of the Medicare system is to increase the eligibility age from 65 to 67 years.  This has been done in the past.  Originally, everyone was eligible for Medicare at age 65.  As the rolls of retirees increased by the millions every year, later-born “Baby Boomers” had to wait.  For example, someone born in 1945 or before could enroll in Medicare at age 65.  Someone born in 1946 had to wait until they turned age 66.  There are no figures to show how much this later enrollment was offset by “Boomers” who decided to take early Social Security at age 62.

The proposal to raise the age of eligibility from 65 to 67 has been cited as a potential solution to extend the life of Medicare.  This proposal would save the Federal government money.  However, doing this would shift the costs to most of the 65 and 66 year olds or to employer plans.      

The Kaiser Foundation estimates that the increased state and private sector costs would be twice as large as the net Federal savings.  The goal should be to slow the growth of healthcare cost throughout the system.   At the same time, this proposal would extend coverage to all Americans of retirement age.  The Office of Budget Priorities has made a number of recommendations to alleviate the problems of Medicare.                                                

Shalloway & Shalloway, P.A., is located in West Palm Beach, FL and serves clients in Palm Beach, Broward, Dade, Okeechobee, Martin and St. Lucie Counties.

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