Sample Letter Informing Medicare Patients of Decision to Opt-Out of Medicare

To: Patients whom I have treated under Medicare until now

This is to let you know that I have decided to drop completely out of Medicare and all Federally reimbursed programs. What this means to you is that you will not get any money whatsoever back from the Federal Government after I have seen you in this office (or in the hospital). Let me quickly add that, if you wish, I will be glad to continue taking care of you - and this will be at a price that you can afford. I will cover this aspect of things later in this notice. All of this does not mean that you will be restricted in using your Medicare for any other physician or for hospital expenses. This only applies to my care.

There is no one forcing me to do this. Medicare has not excluded me from the program.

The reasons behind this are known to many of you with whom I have spoken about this in the past. In essence, the situation is now such that I have difficulty taking care of patients over the age of 65 in the same way that I take care of patients under the age of 65. A key problem is that the Medicare rules have become sufficiently complex that I am very concerned that a minor computer coding error could create drastic penalties for me. Medicare has now indicated that, even if the computer coding mistake is innocent and there is no intent to defraud, severe penalties may nevertheless be imposed.

I have been thinking about doing this for some time, but have held back for obvious reasons - largely related to the problems that it will create for patients. At the very least this will be a nuisance and inconvenience for them. For others, however, this will be a major financial problem. I am very much aware that Medicare has been a great financial help to many. Therefore I have decided that, for patients who are of significantly limited means, we will simply explain what the standard charge is (in other words, the charges we have been making all along to patients under the age of 65). Those who cannot manage that charge may reduce the charge themselves to the level that they feel they can afford. A patient will need to tell us what is within their means in each individual case. Once the patient indicates what he or she feels is a personally manageable charge, then we will accept that.

Still, I know there are some who will be unhappy with this plan. Therefore I will be glad to transfer their records to the physician of their choice, preparing a summary and making appropriate photocopies of laboratory work, tissue reports, and the like.

For those who would like to stay with me (whether or not they can pay the standard charge should not be the deciding factor), then the Federal Government demands and requires that I have each patient sign an understanding which explains that Medicare will not be reimbursing them anything whatsoever. Once again, this does not mean that they will be restricted in using their Medicare with any other physician or for any hospital expenses. It only applies to my care.

Your Doctor