Original (traditional) Medicare
Medicare Part B covers medically necessary specialist visits and outpatient diagnostic tests, such as an ECG, echocardiogram or stress test. After you meet the yearly Part B deductible, you generally pay 20% of the Medicare-approved amount, and a Medigap or secondary plan may cover some or all of that. Traditional Medicare does not require a referral to see a cardiologist.
Medicare Advantage (Part C)
Medicare Advantage plans are run by private insurers and have their own networks and rules. Many require a referral from your primary care doctor and prior approval for some tests. We work with several Advantage plans, including Humana, WellMed, Wellcare and Cigna HealthSpring. Check that your specific plan lists our practice.
Texas Medicaid
Most Texas Medicaid members are enrolled in a managed-care plan. We work with Texas Medicaid and plans such as Molina Healthcare, Community Health Choice, Amerigroup Texas and Superior HealthPlan. Medicaid plans usually require a referral from your primary care provider before a specialist visit.
Medicare and Medicaid together
If you have both (dual eligible), Medicare usually pays first and Medicaid may help with the remaining costs. Bring both cards to your visit.