Need to find a new Texas doctor. Thoughts?

[Aaron and Peter]

Just became Livingston residents. We were hoping to keep our old doctor in CA for a while, but found out that she won’t be able to see us now that we aren’t CA residents. But not sure we want to have a doctor based in Livingston, we might prefer one in a larger market. Does anyone have a doctor in a larger Texas market that gets the full time lifestyle? Any pointers for me? We have Anthem Blue Cross PPO, so we are flexible in that way. 

[Chalkie]

Are you sure that your current plan covers you in Texas at all? I just entered the Livingston zip into the Anthem website and it said that coverage was not offered in that area. I think perhaps that is the reason your current doctor will not/can not see you, the plan you have is for California. There is a Blue Cross of Texas, however. 

[Kirk W]

1 hour ago, Chalkie said:

Are you sure that your current plan covers you in Texas at all?

If your insurance is good in TX, then you would have several options to select from. Our doctor while we were fulltime out of Livingston was one in Ft. Worth, then later we moved to one in Wylie, near a place that we stopped frequently. If you spend time in Livingston, then you are not far from the Houston area, which has a wide choice of doctors and medical facilities. 

[fpmtngal]

I would definitely research your insurance - health insurance is not “transportable” out of state as far as where it can be sold.  I had had a California Anthem PPO/Medicare supplement plan through my retirement plan, but as soon as I moved out of state, I was no longer covered by it - even got a letter from them as soon as they saw the post office change of address.  Since I already knew about this (I have a sister who moved around a fair bit and was always buying new insurance policies every time she moved), and since my retirement plan contracts with Via Benefits for their out of state retirees, I contracted them for a Texas supplement policy.

That’s about all I know about medical insurance.

Baylor St. Lukes has a clinic in Livingston.  I had an appointment with one of their doctors when I thought I was going through Livingston this fall (didn’t happen, but that’s a long story).  Not knowing anything about the medical community around there, I figured that a large, well regarded system might work well and could potentially give me access to specialists in Houston.

Houston has a lot of excellent medical facilities.  If I had known anyone in Texas that could have helped me through cancer treatment, I might be there now at MD Anderson.  Instead I found out that they had a partnership with Banner and had a satellite facility in Phoenix, where I do have friends.  My Texas supplement plan is Humana and Banner MD accepts it.

Good luck with your search and medical care.

[ms60ocb]

I had good luck going to an urgent care facility and asking for a list of doctors. The lady was real helpful, of course most were connected to the local health system. I was impressed with both picks i used from the list. For Dentists, my wife talked to others in the RV park.

Clay

[ms60ocb]

4 minutes ago, fpmtngal said:

Texas supplement plan is Humana and Banner MD accepts it.

Like wise I have Humana as my supplement and I'm under the impression it is good anywhere Medicare is accepted. In May we left Texas (my legal resident) about a month earlier than planned because of my cancer diagnosis. We left Texas because we didn't want to spend the hot summer there. Little I expect to spend the winter in NW Illinois, They are forecasting  a warm up to 32 degree in 9 days.

My wife is a legal resident of Illinois so last week we got our first Covid-19 Vaccine shot. Did go to WI for the shot as no one is administering locally to walking  seniors (still working nursing and teachers). Many winter Texan friends tell me they may have to go home for the shot except for Veterans. I'm glad to hear the Veterans are being treated right althou another Veteran tells me his wife can not be included.

Clay

[fpmtngal]

1 hour ago, ms60ocb said:

Like wise I have Humana as my supplement and I'm under the impression it is good anywhere Medicare is accepted. In May we left Texas (my legal resident) about a month earlier than planned because of my cancer diagnosis.

Yes, Humana supplement can be accepted anywhere Medicare is accepted - that is, if the medical provider accepts Humana.  I ran into that at UCLA, my old medical provider.  They said they didn’t accept Humana, claimed they had no way to bill them (only partly true, Medicare said they would pass on the billing to Humana - at least that’s what Medicare said) and bottom line, wouldn’t take me as a patient, even though I had been one for 20 years.  So I lost my PCP, my ophthalmologist and a couple of specialists.  

I’ve replaced my PCP with one in Phoenix, have a couple of new specialists with Banner but have yet to replace my Jules Stein Eye Institute specialist ophthalmologist.

[LiveWorkDream]

Oh boy you've touched a nerve with me. I recently wrote about the sorry state of health-insurance for full-time RVers who are under Medicare age. It's gotten worse with every passing year for younger full-timers. As of 2021, there are no PPO plans for TX residents who buy on the Federal Healthcare Exchange, just HMOs. HMO plan members who buy on the exchange are not covered for anything but extreme emergencies when traveling outside of Texas. My husband and I fall into that category. 

You didn't say if you are or are not 65 or younger (we are). We found a relatively good clinic in Kerrville for preventive care, but we wouldn't bet our lives on it or seek care there for any kind of chronic illness. As HMO members, you do have the option of changing where you want to get care within Texas, so you are not limited to MDs in Livingston. As for us, next time we seek preventive care in TX, we will choose a physician in the greater Austin area where there are more plentiful provider choices.

Edited February 15, 2021 by LiveWorkDream

[NCMEDIC]

The answer, of course, is universal single-payer healthcare.   It would be good nationwide, without copays or deductibles.

But.......I have no confidence it will happen in my lifetime.

[TXiceman]

On 2/12/2021 at 10:22 AM, fpmtngal said:

Yes, Humana supplement can be accepted anywhere Medicare is accepted - that is, if the medical provider accepts Humana.  I ran into that at UCLA, my old medical provider.  They said they didn’t accept Humana, claimed they had no way to bill them (only partly true, Medicare said they would pass on the billing to Humana - at least that’s what Medicare said) and bottom line, wouldn’t take me as a patient, even though I had been one for 20 years.  So I lost my PCP, my ophthalmologist and a couple of specialists.  

I’ve replaced my PCP with one in Phoenix, have a couple of new specialists with Banner but have yet to replace my Jules Stein Eye Institute specialist ophthalmologist.

My understanding is if the facility accepts Medicare, they have to accept the supplement plan.  You need to report these clowns to Medicare and the supplement plan.

Ken

[Kirk W]

3 hours ago, TXiceman said:

My understanding is if the facility accepts Medicare, they have to accept the supplement plan. 

I found this answer on the Medicare website, after much searching.

Quote

 If a doctor accepts Medicare itself, which is your primary coverage, then they will also accept your Medigap plan, regardless ...

However, I also found the following information on a provider's website.

Quote

 Doctors or hospitals from which you receive care are not required to accept payment from Medicare Advantage Plans.

 

[2gypsies]

The OP didn't say if he was on Medicare or not and is he actually living permanently in Livingston or just has a mail service.

If you have Medicare and a Medicare supplement you can use it anywhere in the country. We did - even surgeries in different states.  Easy to get doctors.

If you have Medicare and a Medicare Advantage plan you can't use it freely countrywide.

[Jaydrvr]

1 hour ago, 2gypsies said:

The OP didn't say if he was on Medicare or not and is he actually living permanently in Livingston or just has a mail service.

If you have Medicare and a Medicare supplement you can use it anywhere in the country. We did - even surgeries in different states.  Easy to get doctors.

If you have Medicare and a Medicare Advantage plan you can't use it freely countrywide.

Again,  the notion persists that Medicare Advantage plans are limited to local usage only. That's just not accurate. As with most health plans, if you select an HMO, that's generally limited geographically to your local area,  except for emergencies. If you select a PPO, as we have, you can have broad coverage nationwide. We've had complete success with doctors and hospitals in multiple states on multiple occasions.  Easy peasy. Jay

[TXiceman]

5 hours ago, Kirk W said:

I found this answer on the Medicare website, after much searching.

However, I also found the following information on a provider's website.

 

But what about Supplement pans?  They are different from Advantage plans.

 

Ken

[Barbaraok]

5 hours ago, Kirk W said:

I found this answer on the Medicare website, after much searching.

However, I also found the following information on a provider's website.

 

You are mixing Advantage with Regular Medicare plus Supplemental.  Advantage plans are not accepted everywhere, usually geographical region and there is no Supplemental with an Advantage plan.

[Jaydrvr]

38 minutes ago, Barbaraok said:

You are mixing Advantage with Regular Medicare plus Supplemental.  Advantage plans are not accepted everywhere, usually geographical region and there is no Supplemental with an Advantage plan.

Yet again, not entirely accurate. PPO plans are generally accepted nationwide. HMO plans are likely to be geographically restricted. Jay

[Kirk W]

50 minutes ago, Barbaraok said:

You are mixing Advantage with Regular Medicare plus Supplemental.  Advantage plans are not accepted everywhere, usually geographical region and there is no Supplemental with an Advantage plan.

Not mixing them. It clearly states Medicare Supplements are but not Medicare Advantage. Two different programs with two different answers. 

Edited September 9, 2021 by Kirk W

[Randyretired]

We have a Medicare advantage plan and have used it in multiple states.  We haven't had a problem  finding medical care.  In fact all of the places we have asked accepted our plan.  There are different advantage plans and levels of coverage.  I wouldn't trade this plan for any other plan.

[2gypsies]

Original Poster:  Sorry if we all got off-track but you didn't say if you're Medicare age or not.

Here's a good comparison article for all three: 

Medicare Supplement; Medicare Advantage HMO; Medicare Advantage PPO:

https://www.ehealthinsurance.com/medicare/supplement-all/medicare-advantage-vs-medicare-supplement-plans

[Zulu]

On 9/8/2021 at 2:35 PM, 2gypsies said:

If you have Medicare and a Medicare supplement you can use it anywhere in the country.

That's what I thought until we got to TX. We tried to use a medical facility near Corpus Cristi, but we were told that they don't accept "federal" insurance (ie Medicare).

On that same note . . .

[Barbaraok]

Not all hospitals nor physicians, etc., take Medicare, but the overwhelming number do.  If you had typed Corpus Christi Hospitals that take Medicare into a search you would received several leads as well as dozens of physicians of all types who accept Medicare.   I have no idea how far away from Corpus Christi you actually were, but large metro areas will have both physicians, hospitals, and urgent care centers that will take Medicare.   We've been all over the country and have never been in a place where they didn't accept Medicare patients at urgent care or emergency rooms, which is what we would be going to since we have our normal physicians in the Mesa, AZ area who all take Medicare.

[Zulu]

45 minutes ago, Barbaraok said:

We've been all over the country and have never been in a place where they didn't accept Medicare patients at urgent care or emergency rooms . . .

Well, I have, so can we leave it at that?

[sandsys]

Some doctors don't think Medicare pays enough to make it worth their while to do the paperwork required. If they have enough other patients to keep them busy, why should they?

[Barbaraok]

11 hours ago, Zulu said:

Well, I have, so can we leave it at that?

Not one physician in the area, not one emergency room?  Any hospital that accepts any federal funding has to accept Medicare.    Where was this ?

[Barbaraok]

10 hours ago, sandsys said:

Some doctors don't think Medicare pays enough to make it worth their while to do the paperwork required. If they have enough other patients to keep them busy, why should they?

They wouldn't.   BUT, if you look around at all the specialities that now exist, how many have a preponderance of patients on Medicare.  Retinologists, cardiologists, orthopedics do knee, hip, shoulder replacements,  ophthalmologists doing cataract surgery on assembly line type setup, 4+ per hour,  oncologists, coronary surgeons doing bypasses, valve replacements, stents, nephrologists (kidney), pulmonologists (lung), gastroenterologist (colonoscopies on assembly lines), etc.     

My grandfathers died in 1960 and 1962 (80 and 82 yrs old) of pneumonia, which is now so treatable in most cases it is a short stay in the hospital, maybe with some rehab time afterwards, and then a warning to stay away from grandkids with colds.   Before Medicare, they wouldn't be aggressively treated, but "kept as comfortable as possible" as their lungs collapsed and other body organs shut down.  "It was their time!".  My mother and her sisters lived past 90, and one of those sisters is 98 (I'm named after her, go Auntie Barbara) and head towards 100 and still lives independently with my cousin nearby.   Medicare and the Space Race helped to provide the impetus for huge developments in medicine that now help people of ALL ages.