“Currently, about 40 million Americans have Medicare insurance, according to medicare.gov.”

An article in The New York Times documents a disturbing new trend: As millions of baby boomers become eligible for Medicare in the coming years, more doctors are opting out of the insurance system and turning away patients with Medicare coverage.

Citing low reimbursement rates and too much paperwork, internists, gynecologists, and other specialists are shifting the cost burden to the patient. These doctors can charge whatever they want, but they cannot bill Medicare (nor can the patient) for reimbursement for their services.

Another concurrent trend creates further complications: If you’re looking for an internist (a primary care doctor who treats adults) who accepts Medicare, the challenge is even greater. According to the New York-Presbyterian Hospital’s website, “only 37 percent of the hospital’s 93 affiliated internists accept Medicare.”

Julie Connelly, the article’s author, advises those approaching the age of eligibility to get a head start on things. Patients should talk to their current doctor about keeping them on their service after their 65^th birthday, even if that doctor does not accept Medicare.

And if you can’t find a doctor who accepts Medicare? Don’t give up. Ask about signing a private contract that “stipulates the patient will be responsible for paying the doctor’s fees.” Be sure the contract lists exactly what those fees are and what they cover. Connelly says some doctors may be willing to negotiate and tailor prices to what patients can afford.

There are other options too, one being utilizing the increasingly popular, stand-alone urgent care centers. Currently, there are 18,000 of these centers in the U.S., and nearly all of them accept Medicare. Boutique or concierge care is also an option, albeit a more costly one.

Yet another sign of the times, the amplified need for more doctors to participate with Medicare lends itself to the creation of these niche operations like urgent care or concierge care. I’m sure there are pros and cons to both care settings (urgent/concierge vs. primary care), but it might be too early to say at the moment which is best. I do know for sure that a lot of baby boomers will need a lot of care in the coming years, and our health care system probably needs to change to meet those needs.

What are your thoughts about the ever-changing health care environment? Have you heard stories about patients with Medicare being turned away or being forced to pay higher costs? Tell us all about it!

-Michelle Seitzer