Here’s a question that often comes up in conversations between senior adults: Can you have two primary care doctors with Medicare?
The answer is yes, you can have 2 primary care physicians if you are enrolled in a Medicare plan. Medicare doesn’t stop you from having 2 primary care doctors at the same time.
But whether or not that’s the best idea depends on several factors.
What is a primary care physician
A primary care physician is also known as a primary care doctor, or a primary care provider. They provide fundamental, essential — in other words, primary — healthcare.
They’re typically the first point of contact for routine checkups, vaccinations, chronic condition management, and Medicare Annual Wellness Visits.
A good primary care doctor will also maintain a thorough record of your health. This is crucial in coordinating care if you also see one or more specialist care providers, such as a podiatrist who helps you manage complications in the feet and legs brought on by diabetes.
Ideally, you should have a long-term association with your primary care doctor. When your primary care physician has solid knowledge of your unique health history, individual care needs, and lifestyle, this can help lay a strong foundation for reliable continuity of care.
What is the main reason for having two primary care doctors
Generally, once you’ve found a doctor you can trust, one primary care physician is enough for most people.
But in some cases, you might need more than one primary care provider. The most common reason for this is if you split your time between two homes in two different cities or states.
How can I find a good doctor near me
When searching for a primary care physician, you always want the best primary care doctor near you.
Start with a simple web search. Typing “good doctors near me” in the search bar will give you a list all the physicians in your vicinity. From that list, pick a care provider who meets your requirements.
As a senior adult aged 65 years or above, you would be looking for a doctor who specializes in Internal Medicine, Family Medicine, or Geriatric Care.
Read all patient reviews and testimonials you can find for your potential care provider, and count their CAHPS stars.
What are CAHPS stars
The Centers for Medicare and Medicaid Services (CMS) have detailed databases of healthcare providers, hospitals, home and hospice care providers, and other care services affiliated with Medicare.
CMS regularly conducts Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys to determine patient experience and quality of care provided. Using this information, all licensed care providers are given stars. The more stars a doctor has, the higher they rank on the performance scale.
You can search for your doctor and check their star rating using this tool on Medicare’s website.
Found a good one!
When you find a care provider who has the requisite qualifications, you can call their clinic and set up an appointment. At the appointment, pay attention to whether the doctor:
– Listens and gives you plenty of time to talk about your health concerns without rushing you
– Asks open-ended questions
– Is non-judgmental
– Prioritizes preventative care
Here, in more detail, are the 6 signs you should look for when choosing a primary care provider.
Can you have two primary care doctors with Medicare
This depends on what kind of healthcare plan you have. Original Medicare and Medicare Advantage each take a different approach to the question.
Original Medicare vs Medicare Advantage
Below is a quick look at how Original Medicare and Medicare Advantage approach the question of having multiple primary care providers.
Having two primary care providers if you are enrolled in Original Medicare
Patients enrolled in Original Medicare (Part A and Part B) can have two primary care physicians. Actually, you can have as many as you like. Original Medicare puts no limit on the number of doctors you can see.
The only condition is that you cannot see more than one primary care provider on any given day. If you have two or more primary care providers, you cannot schedule appointments with both on the same day.
You can go to any doctor who accepts assignment, regardless of their insurance network. ‘Accepting assignment’ means the doctor sees patients on Original Medicare (Part A and Part B) plans, and has agreed to take whatever payment amount Medicare has approved for a healthcare service.
Watch this quick video on Original Medicare vs. Medicare Advantage for a clearer understanding of your options.
Always confirm beforehand if the doctor you wish to see accepts assignment, otherwise it may cost you extra.
Having two primary care providers if you are enrolled in Medicare Advantage
Patients with a Medicare Advantage (also known as Part C) plan will have to check their particular plan, or ask their insurance provider if they are limited to only one primary care doctor, or if they can see more.
In the event that you are allowed to see more than one primary care doctor, you must make sure they both belong to the same insurance network as your specific Medicare Advantage plan. Seeing an out-of-network care provider can result in a very expensive bill.
Advantages and disadvantages of having two primary care doctors
Having two primary care doctors may seem like a great idea, and sometimes it is. But it may pose quite a few challenges too.
Advantages of having 2 primary care providers:
- If you have two homes and spend a considerable chunk of your time at each, having two doctors lets you see the one closest to you whenever you need.
- You can get a second opinion if you’re not satisfied with the medical advice from either doctor.
- You can double check care or treatment plans by running the advice of one doctor by the other.
Disadvantages of having more than 1 primary care provider:
- Instead of coordinated care, you get fragmented care. There’s also a higher risk of medical errors happening if your multiple primary care doctors can’t communicate well and clearly with each other.
- Your health record may not be properly maintained. Repetition, clutter, and failure to note important details may lead to billing errors and problems with your insurance, as well as diagnostic or prescription
- There is a higher chance of medication errors, such as overmedication, if two doctors prescribe the same drug. Some drugs may react negatively with others, so it’s crucial that each doctor knows what the other has prescribed.
- Your out-of-pocket costs may be higher. Having to get duplicate lab tests, drug prescriptions, and other care services may push your expenses up.
- Your doctors may have different, perhaps even conflicting, approaches to providing care. This can disrupt continuity of care and lead to serious problems down the road.
Should I have two primary care physicians or not
It makes sense to have more than one primary care physician if you have to spend large amounts of time in two different locations. Otherwise, one good doctor should be plenty.
But, if you still want to have two doctors, you might designate one as your main primary care provider and the other as the backup.
This might help reduce errors in continuity of care and lessen the scope for medication mistakes, all of which works to your benefit.
At the end of the day, the most important thing is finding a doctor, or doctors, who understand your health history and care preferences.
Looking for a primary care provider who understands Medicare?
Visit intracare.com to explore trusted doctors in your area.