I’m on Medicare, and My Doctor’s Retiring. What Should I Do?

A trusting, respectful relationship with your healthcare provider is a powerful thing. Research shows that strong communication and mutual understanding between doctors and patients can lead to better health outcomes. So, it makes sense to feel concerned if you hear that your primary care provider is planning to retire soon. 

A 2022 report by Association of American Medical Colleges found that more than 46% of practicing physicians were over the age of 55. As these doctors reach retirement age, many patients will have to make a tough decision about who they’ll see for routine checkups or specialized treatment in the future. 

By preparing for these changes, you can avoid disruptions to your care and start off on the right foot with another doctor. In this article, we’ll examine some of the most pressing questions that people on Medicare need to consider before picking their next primary care provider. 

Does Your Plan Have a Provider Network? 

When you’re looking for a new doctor, it could make a difference whether you’re enrolled in Original Medicare (Medicare Parts A and B), which is administered by the U.S. federal government, or you’ve substituted a Medicare Advantage plan from a private insurance carrier. 

If you’re on Original Medicare, you can see participating healthcare providers anywhere in the U.S. However, you should confirm that a doctor you’re considering accepts assignment. Accepting assignment means they take the Medicare-approved amount as full payment for services. Otherwise, you may pay more out of pocket. 

Most Medicare Advantage plans, like other private insurance plans, require enrollees to see doctors and visit pharmacies that are in a provider network to get the most out of their benefits. This network enables your insurance carrier to coordinate care between multiple providers and keep your costs lower, but it may limit your options when you’re looking for a healthcare provider in your area. Before setting up an appointment with a doctor’s office, contact them to make certain that they currently work with your plan. 

How Do You Choose a Primary Care Physician? 

Once you’ve narrowed your options to healthcare providers who take your insurance, there are plenty of other factors to consider. Referrals are a great place to start, especially if your retiring doctor has recommended a colleague with a similar approach to practicing medicine. You can also ask friends and family members if they’ve had a great experience with a healthcare provider near you. 

Decide what kind of doctor you would like to see as your primary care provider. Your choices may include the following: 

• A general practitioner or family medicine physician can treat people of all ages for a wide variety of healthcare needs. Some hold a degree as a doctor of osteopathic medicine (DO) rather than a doctor of medicine (MD). DOs may take a holistic approach to healthcare with a focus on the musculoskeletal system. 
• An internal medicine physician has specialized knowledge of internal organs. These doctors help adult patients with complex healthcare needs such as multiple chronic conditions or long-term illnesses. 

Convenience may also be a priority. You’ll want to find a doctor whose office you can get to easily and who is available for appointments that fit into your schedule. Many healthcare providers also offer telehealth services so you can consult with them from your computer or phone. 

How Can You Make a Smooth Transition to a New Provider? 

You have a right to your own medical records under the Health Insurance Portability and Accountability Act (HIPAA). Before seeing a new healthcare provider, it’s a good idea to arrange to have this information transferred between offices or sent to you. That way, the doctor you’re meeting can get a detailed understanding of your medical history including any treatments you’re currently undergoing or medications you’re taking. 

If both your old doctor’s office and the new one you’re visiting have up-to-date electronic health records systems, this process should be quick and easy. You just need to fill out a consent form to have the information sent over. However, some healthcare providers still rely on paper records and fax machines, so there can be delays. 

Under HIPAA, doctor’s offices are allowed to charge a “reasonable fee” for the costs of copying and mailing your records. That amount can vary depending on state laws and your healthcare provider’s policies, or there may be no fee at all. Ask your old provider if there’s any charge when requesting your records.  

What Should You Look for During Your First Visit? 

Your first visit to a doctor is a chance to get to know them and decide whether they’d be a good choice as your primary care provider. Look for positive signs like these: 

• You feel comfortable in the office. 
• Staff members are welcoming and helpful. 
• The doctor listens to you and thoroughly answers your questions. 

Dealing with the retirement of a trusted healthcare provider can be difficult. However, by thinking carefully about what you want out your relationship with a doctor and preparing, you can get your relationship with a new doctor off to a great start. 

About GoHealth 

GoHealth is a leading health insurance marketplace and Medicare-focused digital health company. Enrolling in a health insurance plan can be confusing for customers, and the seemingly small differences between plans can lead to significant out-of-pocket costs or lack of access to critical medicines and even providers. GoHealth combines cutting-edge technology, data science, and deep industry expertise to build trusted relationships with consumers and match them with the healthcare policy and carrier that is right for them. Since its inception, GoHealth has enrolled millions of people in Medicare plans and individual and family plans. For more information, visit GoHealth.com.