Miller Insurance Management

Office: 801-637-4420

Long Distance: 1-800-224-3229

Medical Specialists – and modern medical advancements have extended our life expectancy. Baby Boomers are a part of the growing demand for treatment.  The market is undeniable, and the need for medical treatment and health care, in general, is universal.

The average American is now expected to live to age 78.8 years old. As we age, we will need more health care.

  • The following is a list of the most needed medical Medical Specialists :
  • Family Physicians
  • Internists
  • Pediatricians
  • Psychiatrists
  • Obstetricians and Gynecologists
  • Surgeons
  • Anesthesiologist
  • Pathologists
  • Neurologists
  • Allergists and Immunologists
  • Nuclear Medicine Physicians
  • Dermatologists
  • Physical Medicine and Rehabilitation Physicians
  • Emergency Room Physicians
  • Pulmonary Medical Specialists

There are 120 specialty and subspecialty groups of medical practice.

It has been said that the health care field is predicted to add more physicians to the economy than any other industry in the coming decade.  Doctors are in high demand, and the need will grow faster than the supply of physicians. Specialist groups will be facing shortages. There are 120 specialty and subspecialty groups of medical practice.

Medicare Coverage and Medical Specialists  

 Part B under Medicare pays for 80% of most Medical Specialists’ services. You would pay the other 20%. The best practice is for you to call your insurance company any time you see a medical doctor of any kind. Most Medical Specialists under Medicare advantage charge an extra fee to see them. You should make sure you understand all of the costs.

Referrals and Medical Specialists

It is usually a good idea to start with your primary care physician when you need to see a Specialist. You may have medical conditions that make it so that you do need to see a Specialist. It would help if you considered calling your insurance company to see whether a specific doctor is in-network. Sometimes, it is quicker to get into a Specialist when your PCP refers you to the new doctor. It is a good idea to check with the latest medical provider to see if they accept either your health insurance plan or your Medicare Advantage Plan.

Medical Specialists  Choose Whether to Participate in Medicare

Doctors have a few options when it comes to the Medicare program. They have the choice of being either a participating or non-participating physician, or they have the choice to altogether opt-out of the program.

A participating physician agrees to accept the Medicare-approved charge as full payment for services. This is also known as taking an assignment. A non-participating physician can determine on a case-by-case basis whether he or she will accept the Medicare-approved charge in the Medicare fee schedule. If a non-participating doctor chooses not to accept the Medicare fee schedule or assignment, the doctor can charge up to 15% more than the Medicare-approved cost of services provided. Physicians who opt-out of the Medicare system cannot bill Medicare or other Medicare private insurance plans for services. Instead, the entire bill is the responsibility of the patient.

Many health insurance plans are similar. The physicians can decide whether they want to participate or not.

In Summary,

Hopefully, the above information sheds some light on treatment from a physician, when to see another doctor, when to get a referral, different types of coverage and fees, in-network physicians, Medicare fee schedule, when to call your plan regarding a physician or specific fees, etc.

Note: Now through December 7th is the AEP or Annual Enrollment Period for Medicare, and this is a great time to call and compare plans and see how you can save money and to see what physicians are on new plans that you may benefit from!

Call John Miller Today!!! Locally 801-637-4420, or 1-800-224-3229