Medicare Opt-Out Effective 9/1/2020
Greetings,
As of September 1, 2020, I will no longer be accepting Medicare.
Dr. Orner’s practice is designed to be a direct primary care (DPC) practice. In this model, the patient pays his or her physician a fixed monthly fee that covers most of your basic health care needs. This model allows for a more direct relationship between the provider and the patient. It also allows improved access to care, longer appointment times with each patient, and the option of nontraditional appointments such as via phone, video conferencing, or even at the grocery store.
When I was first creating this practice, I had a number of patients on Medicare that wanted to follow me on my new adventure. Therefore, I decided to offer what few DPC physicians offer - I became a hybrid practice where the only insurance I stayed contracted with was Original Medicare.
While I meant well, this did not work out well in practice. Despite trying to be clear about Original Medicare vs Advantage plans, people have still been surprised by bills. Those with any form of Medicare Part B were unable to join the membership plan, even when it could save them money. There have also been issues with coverage for non traditional appointment types and home visits. It is not sustainable.
The great news is that this new chapter will allow me to care for all of my patients in the way they deserve. All of the current patients at the practice with Medicare can choose to remain at the practice and I will continue to care for you, but through a different payment arrangement.
Moving forward there are two options.
Join the membership plan at $60 a month.
Meet with Dr. Orner to discuss payment options.
Times are hard. I realize there are some people that are having difficulty paying a $10 copay. If you are unable to pay the monthly membership but want to remain at the practice, call the office to set up an appointment to speak with me and we will figure out a plan that works for you. If you decide that you would rather go to another practice, let me know and we can help you transfer your records.
Medicare does require that all patients with Medicare who receive care from an opted-out provider sign a form acknowledging that they are aware the provider no longer accepts Medicare. Also, those who chose to stay will need to sign a membership agreement and the Medicare required form by October 1, 2020.
Please note, this only affects the use of Medicare at my practice for billing. I am still able to order Medicare-approved labs, imaging, and studies. I can still place referrals to specialists that accept Medicare. Those with Medicare can still use their insurance everywhere else they are used to using it.
Please call the office with any questions.
All the best,
Dr. J. Orner, MD