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Need a Doctor, Hospital or Rehab? Medicare Has Tools to Help

Websites that can help you compare quality, availability of providers and services


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ARTHUR SMITH/AARP

As you are making your Medicare choices for 2020, you'll want to dig deeper than just selecting a plan that looks like it meets your health needs. You'll want to make sure you can see a doctor you'll feel comfortable with and that if you need hospital care you can go to the best place for you.

How can you figure that out? Medicare has some online tools that can help.

"These Medicare tools enable consumers to make more informed choices, and the availability of choice can lead to more competition and reduce costs,” says Niam Yaraghi, professor at the University of Connecticut and a fellow at the Brookings Institution's Center for Technology Innovation.

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Here's a look at the tools available at medicare.gov

Plan Finder helps you find Medicare Advantage and Part D prescription drug plans tailored to your needs. Enter your zip code and personal information, and compare up to three plans at once.

Plan Finder ranks Medicare Advantage plans on a five-star quality rating system based on such factors as how members rate their experiences, customer service and plan performance. The higher the number of stars, the better. Star ratings are updated annually and released in October.

There's a star rating for prescription drug Part D plans and one for Medicare Advantage plans with drug coverage.

Physician Compare can help you find a doctor by name, specialty, solo or group practice, body part or condition. It lists clinicians by how close they are to where you live.

You can filter results by gender, board certification and other factors. Performance scores are available for some physicians in some categories and some locations — but not all.

Once you find a doctor you think you'll like, Physician Compare suggests you call the office. Check if the provider you are considering is a participating Medicare doctor, meaning they accept the Medicare fee schedule amounts and you are responsible for 20 percent of the bill. If they're not a participating doctor, you may have to pay more out of pocket for your care. Doctors go in and out of networks so if you are contemplating a Medicare Advantage plan, double-check that the physician you want to see will be in that plan come January. And some doctors may not be accepting new patients. Physician Compare provides contact information for the doctors it lists.

The Centers for Medicare and Medicaid Services (CMS) has produced a video that gives some examples of how to use Physician Compare.

Hospital Compare helps consumers choose from among more than 4,000 Medicare-certified hospitals around the country, including 130 Veterans Administration medical centers.

In an emergency, obviously you should go to the nearest hospital, but use Hospital Compare in coordination with your physician when you have time to choose your hospital.

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The government uses a one- to five-star rating for hospital quality—the more stars, the better — based on more than 50 measures. The most common hospital rating is three stars.

CMS is planning to update the star system because hospitals and medical groups have raised concerns that the ratings have been inconsistent and present an inaccurate picture. One proposed change: comparing small hospitals only with other small hospitals instead of with all hospitals.

CMS has also produced a guide to choosing a hospital that is available online. 

Inpatient Rehabilitation Facility Compare gives a snapshot of care in more than 1,100 facilities nationwide, using such markers as how often patients get infections and pressure ulcers.

The tool shows you how many rehab facilities there are within 100 miles of your zip code and also provides information on which conditions different facilities have treated and how often.

Hospice Compare allows you to search for hospice care by using either the name of the agency you want to get your care from or your zip code. The site provides information on the quality of care at various facilities and also has a handy checklist of questions you should ask when shopping for hospice care for yourself or a loved one.

Supplier Directory can help locate where to buy medical equipment and supplies, such as diabetes test strips, a commode chair or hospital bed.

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