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Can I keep my doctor?

Recently on our forum a claimant asked, “Can I keep my doctor if I am approved for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI)?”

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The good news is that if the claimant is asking to keep their doctor than they have a doctor and they are getting medical care for their condition, which is the biggest way to improve your chances of winning SSDI or SSI. Winning benefits quickly and easily generally can only be done if you are seeing the right doctors and specialist and doctor getting medical care for your mental or physical health condition.  The right doctors can include qualifying medical sources:

  1. Licensed physicians (medical or osteopathic doctors)

  2. Licensed or certified psychologists.

  3. Licensed optometrists

  4. Licensed podiatrists

  5. Qualified speech-language pathologists

Will I get medical insurance if I get SSDI or SSI benefits?

Claimants who are approved for SSDI will get Medicare 24 months after the date of their disability. SSI recipients will get Medicaid, in most states, at the time of approval. So to answer the question, “Can I keep my same doctor?” really will come down to whether or not you get SSI or SSDI benefits and whether your doctor accepts these insurance plans.

What doctors take Medicare and Medicaid?

There have been studies done by professionals in the healthcare field which have evaluated whether there were a large number of doctors who refused to treat Medicare patients because of the low reimbursement rates and burdensome paperwork requirements.

Details of the reports show that over a three year span in the mid 2000s there was a reduction in the number of doctors willing to accept Medicare patients. But subsequent reports indicated that up to 90% of doctors still are willing to accept Medicare; however, there were “problems in certain geographic areas and where doctors might accept Medicare patients only in limited numbers.”

SSI and Medicaid

SSI recipients will have a more difficult time finding a doctor who accepts Medicaid, although many of the SSI applicants have not had insurance in the past so they may not have been seeing a specific doctor. Recent estimates suggest that less than two-thirds of doctors will take new Medicaid patients.

Why won’t doctors take Medicaid? The general consensus is that Medicaid payments fail to cover even the most basic costs of seeing the patient, and if the doctor takes Medicaid they may not be paid for their medical services.

In recent years, an increasing number of doctors have lowered the number of Medicaid patients they are willing to accept and treat. How does this refusal affect the rest of America? Patients who cannot get routine medical care may seek expensive treatment for their conditions at the emergency room which substantially increases the cost of medical care for all Americans.

Bottom Line

Many claimants who apply for SSDI or SSI and who have been out of work for months or years are glad to receive any type of medical insurance. Other claimants have a strong doctor/patient relationship and want to continue to see their doctor. For these claimants it may be difficult to continue to see their doctor, especially if they are now getting Medicaid. Talk to your doctor about your medical options for continued treatment.
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