Medicare Opt In or Opt Out ?!
2024 is almost here and I am so happy that LPC’s and LMFT’s will finally be able to accept Medicare! 11,000 people turn 65 every day, so there’s no shortage of folks needing services.
As you may have heard me say before…it’s (one of) my missions to educate therapists on Medicare, how it can be a great addition to your practice, and most importantly, PLEASE don’t be afraid of it! I know a lot of you are still on the fence, so here’s some information from my own experience as a Medicare provider, and from hundreds of therapists who have consulted with me about Medicare
It helped my practice scale to seven figures. Yes, seven. Because there is such a need for Medicare providers and not enough of us, I was able to expand into a group and fill my clinicians' caseloads within a month or two.
Endless streams of clients. 11,000 people turn 65 every day, and the need for therapy services will continue to increase. Again, most communities need more Medicare providers and because my practice was known for accepting Medicare, we had a constant stream of referrals.
Paid well in my state. Medicare pays well in my state, but I know that’s not the case for everyone, and in most cases, it doesn’t pay your private cash rate. Medicare can be one additional income stream, but it doesn’t have to be your whole practice.
Ready to enroll? My courses are here to help you, plus you get lifetime access and unlimited replays
Still not sure? Read the pinned posts in the group or watch my previous Q&As, also tagged in the group. You can also sign up for my free Q&A, hosted by Spruce Health, on Jan 16. Secure your spot here
Finally, OPTING OUT. If you want to charge Medicare clients out of pocket for services, you need to formally opt out. This is different from commercial insurance. This means you nor your client can submit to Medicare for reimbursement and opting out lasts for two years. There has been some talk of commercial insurers dropping your contract if you opt-out. I have only seen one local BCBS plan so far with this stipulation. Therapists in the group have posted screenshots from Cigna, Kaiser, and Optum stating their commercial contract would not be terminated- please check directly with your provider rep. If you decide to opt-out, go to your MAC’s website (I have a map on my website here) and search “opt-out”. Each MAC has a form you fill out and mail or fax in.
Remember, I am here to help you with all the facts and information. I billed over 200 sessions to Medicare per week successfully and have helped many other therapists become Medicare providers. Working with Medicare has always been wayyyy easier than commercial insurance. If you’re feeling like you just want to throw your computer against the wall because of frustration- take a breath and schedule a discovery call with me to see how I can help. No use wasting your precious time when I have done it all for you!