If you’re looking to find a doctor that accepts Medicare near you, you’re not alone. One of the most significant challenges for anyone seeking healthcare is finding a great doctor who is within the confinements of Medicare.

Some great resources exist that might help in this endeavor. If you’re looking for quality advice for your particular health circumstances, Bernardini and Donovan can show you the tools to find the right doctor and the right insurance plan. We offer insurance services in the Inland Empire, including information on Medicare coverage in the Inland Empire.

Today, the B&D team will clarify the differences between Medicare and Medicaid. We’ll also highlight some questions to consider as a precursor to finding the ideal Medicare doctors that suit your needs along with additional resources that might help.

Medicare vs. Medicaid

Medicare is a program aimed to help adults over the age of 65 to receive Medicare Health Insurance. It also provides health insurance for disabled adults under 65 and anyone who has been diagnosed with End-Stage Renal Disease (permanent kidney failure). Medicare is a federal taxpayer-funded program run by the Centers for Medicare and Medicaid Services, a federal government agency, and generally remains the same across the US states.

Medicaid is an assistance program for low-income people of every age. With this program, patients typically do not pay any amount for their covered medical expenses. In some cases, a small copayment is required. This, unlike Medicare, is a federal-state program and varies across the US states as state and local governments run it within federal guidelines.

What Doctor Accepts Medicare

When you hear someone say a provider is a “Medicare doctor,” or that doctor “accepts Medicare,” that generally means that there’s a Medicare-approved doctor available who can agree to accept Medicare Assignment. The doctor (or another provider) agrees to accept what Medicare pays for that service and won’t charge you more than the standard Medicare deductible or coinsurance/copayment. The Medicare doctor also can’t charge you for sending a claim to Medicare.

Many people have health and medical questions and might feel overwhelmed because these are complex topics. Sometimes, you might not even know what questions to ask. At Bernardini and Donovan, we specialize in health and medical insurance services.

If you have questions about Medicare coverage, or you want to know if there’s a doctor who accepts Medicare near you, our team can help! Let’s start by addressing a few things that can hopefully ease the process of finding suitable Medicare coverage near you.

Do All Doctors Accept Medicare

Before jumping into finding a suitable doctor, it’s important to know the following information in advance:

  • Is the doctor “in-network”?

If you have Original Medicare, you can visit any doctor that accepts Medicare assignments. However, if you have Medicare Advantage (such as an HMO or PPO), you may be required to see in-network doctors in order to be covered.

Out-of-network or non-contracted clinicians are under no obligation to treat Medicare members, except in emergency situations. This means that Medicare coverage near you might be limited. You also may pay more for doctors who are out-of-network, or you might not be covered at all. Also, the costs that you experience for out-of-network doctors may not count towards your out-of-pocket maximum.

  • Do you have medical conditions you need the doctor to be familiar with?

If you have a rare or life-threatening condition, you may want a doctor who is familiar with it. For example, if you think you may need hospice care in the near future, a doctor with training in hospice care might be a good fit for you.

  • What plan do you have/How much are you willing to spend?

This is a matter of what you want vs. what you have or can afford. Do you have basic Medicare, Medicare Supplement together with basic Medicare, or a Medicare Advantage plan?

If you don’t know what all of these options mean to you, our Medicare page can help explain these options in more detail.

Finding Suitable Medicare Coverage

Your satisfaction with Medicare may depend upon finding a plan that will help you access convenient and capable doctors. Many of you will also hope to choose coverage that will allow you to keep the primary care doctor that you may already know and trust. Below are some brief rundowns of what each plan consists of.

When a primary care doctor accepts Medicare Assignment, that means he or she agrees to bill Medicare-approved amounts for various healthcare services. You can keep your costs as low as possible by seeking out a primary care doctor who accepts Medicare Assignment. Medicare offers a handy search tool that you can use to find nearby doctors who agree to accept Medicare Assignment and bill Medicare for their share of the bill.

If you’d rather not have to limit your choice of doctors to those who will agree to charge only what Medicare allows, you can consider buying Medicare Plan F or Plan G to supplement Original Medicare. These two supplements will typically cover excess charges, or bills in excess of Medicare’s limits. This benefit can help broaden your choice of caregivers. It doesn’t just apply to first-line primary care doctors but also to specialists. Still have questions regarding different Medicare plans? Our health and medical insurance services in the Inland Empire are designed to help Inland Empire residents clarify health and medical questions so you’re not in this alone.

Finding A Medicare Doctor Near You

Like most people, you probably want to find a likable, qualified, and conveniently-located doctor. This doctor might be the one you see most often, so the best strategy for finding your doctor will depend upon the kind of Medicare insurance you have. We’ve already touched base on the different Medicare plans available, so make sure to take that into consideration, as that might affect your choices.

If you are enrolled in a Medicare Advantage plan, your plan will also provide a directory of Medicare doctors in its provider network, if applicable. If you aren’t sure, call your Medicare doctor’s office and ask whether your plan is accepted before you make an appointment.

If you have Original Medicare, you don’t need to use doctors in a plan network. You can see any doctor you choose. But you can typically save money if you find a Medicare doctor who accepts Medicare payment terms (assignment). You may want to ask the doctor before you make an appointment.

Finding a suitable Medicare doctor is as simple as asking for referrals from friends, relatives, coworkers, and/or neighbors. You can also check with your insurance plan, medical societies, hospitals, and accreditation organizations. Just keep in mind that these resources cannot ensure that a particular doctor is the best one for you, but they do provide information on a doctor’s knowledge and skills.

Medicare Coverage in the Inland Empir

You might still find yourself having questions or concerns regarding your healthcare needs. Understanding Medicare and how to get the best care possible can pose a significant challenge. That’s why we at Bernardini and Donovan strive to help you understand the process, answer your questions, and help you find medicare doctors in your area!

At Bernardini & Donovan, we provide health and medical insurance services in the Inland Empire, so residents in or around the area who have questions can reach out to us for more information!

Don’t hesitate to contact us. There is no additional cost to you, so make sure to utilize our resource of expertise!

Understanding Medicare

Understanding Medicare

Understanding Medicare

Come your 65th birthday, and you’ll enter into a whole world of benefits, discounts and special deals. Whether you’re out to see a movie, looking for a meal or searching for insurance, you can be sure to find a specific deal just for you! Medicare is available to anyone 65 and older and who have worked full time while paying taxes for at least 40 quarters or the equivalent of 10 years. And while Medicare may be an unfamiliar topic to those approaching their golden years, here we have broken down and explained each part and every option available to you. Upon your eligibility for Medicare, do not hesitate to reach out for consultation in choosing the plan that is best for you.

What are the four parts of Medicare and what do they cover?

Medicare has four parts and two ways in which you can put your plan together. The first part, A, includes hospital coverage. Upon reaching retirement age, you will be automatically enrolled into part A, and it does not include a premium. Part B covers physician and outpatient medical care. Unlike A, you must select this option as this does include a premium, regardless of how much you’ve worked. This premium is a sliding scale, dependent on your income. You can find more info on this premium cost at when you search for Plan B premium. In a nutshell, if you earn less than $85,000 a year in retirement or $170,000 as a couple, then your monthly premium for Part B in 2019 will be $135.50.

Understanding Medicare

Parts A and B do not cover everything, however. With these, you will still be responsible for paying for several other services. So, how can you supplement? One option is to opt for Part C which is referred to the Medicare Advantage Plan. This plan bundles together parts A, B and the fourth part of Medicare, Part D all into one package. This product is known as a Medicare HMO. If you decide to enroll in this plan, you’ll select a primary care physician who will direct your care and will refer you to any specialized care you might need.

The final option, besides the HMO, is a Medigap plan or a Medicare Supplement. This is a health insurance policy that you’ll buy from an insurance company with an additional premium. These vary quite drastically, typically ranging from $80-$150, depending on what coverage you require. The Medigap plan does not bundle in Part B which includes drug coverage. Therefore, you’ll have to buy drug coverage which generally costs anywhere from $12 to over $100 a month. This is all dependent on the type of coverage you need.

Understanding Medicare

So what’s best for me?

With so many options, it is often difficult to determine which plan is best for you. We suggest that you take a look at your budget as well as the sort of coverage you received before retirement. Consider what you can afford. For guidance, we suggest that those nearing age 65 on a fixed income and those that do not have a large income, opt for the Medicare Advantage Plan. This will require little out-of-pocket cost and no additional premium payment to the typical $135.50. For those with a higher income, which are used to a PPO health plan, Medigap or Medicare Supplement plan will be the best option. With this, you can expect to pay about $300 a month. This breaks down as: $135.50 + $145-150 for supplementary coverage + $20-30 for drug coverage. With any plan, you ought to refer to your income and health care needs. It is important that you enter into retirement with confidence in your health insurance plan.

As you approach 65, you will be presented with several options for health care coverage. Do not be overwhelmed however by the magnitude of this choice. There are simple ways to break down the decision and choose what is best for you. Please, give us a call with your questions and concerns. We’re here to assist you as you enter into the years of getting the best deals on just about everything!

Values of Bernardini & Donovan

Values of B&D

Values of Bernardini & Donovan

At Bernardini and Donovan, we love serving our clients and partners. And we are dedicated to providing you,  your families, and your businesses with insurance services. We do this by following a dedicated set of values which directs our communication and service.


We are here to help you. We understand that your health is vital and that many of you need good health insurance to help the cost associated with preventative care as well as care whenever illness or injuries occur. That’s why we want to do everything we can to help you. If you are tired of trying to figure out health care on your own, we are here to answer your questions and walk alongside you to ensure that you get the health insurance that you need.


Our health insurance market has been flooded with change over the last few years. To the point that many people cannot keep up. We know that it’s hard to keep up in a niche market, so that is why we do it for you. As you have questions about new policy, your best options for your business or when you are starting Medicare; we are here to give you the most up to date information.


Webster’s dictionary defines trust as the “assured reliance on the character, ability, strength, or truth of someone or something.” We strive to continue to be above board, up front and honest with all of our clients. We seek to communicate effectively and promptly especially when deadlines are so final with health insurance. And we hope to build lasting relationships with our clients. This isn’t a single transaction, but a desire to see you turn to us for any of your health insurance needs.

We want you to succeed and do everything we can to make the health insurance process as easy as possible. Please contact us today if you have questions about your health insurance.

How Job-Based Coverage Affects You

What Does Your Employers Plan Mean For Your Subsidies?

For most, health insurance options through your workplace are good news. If, however, you had plans to secure subsidies to help you pay for an individual health plan outside of your work, your employer’s offer of coverage may be a problem for you. Make sure you do not opt out of health care through your work only to find yourself without tax credit.

How does qualification for health care subsidies work? According to the Affordable Care Act (ACA), anyone who is at an income level of 400% or less of the federal poverty levels can qualify for tax credits to help them cover the cost of health insurance. These subsidies are available in your specific state and can be applied for during the open enrollment period, which ends February 15th.

If, however, you work somewhere that offers affordable health insurance and you choose not to accept a plan through your workplace, you will not qualify for subsidies. The same is true if you are eligible for coverage through Medicare. The government is committed to helping every American get the health care he or she needs, but if you choose to opt out of perfectly good coverage there will be no aid for you. That is because your job-based plan counts as the now federally mandated minimum essential coverage. Securing a plan through your workplace will also help you avoid the tax penalties that could be assessed if you do not have coverage.

To understand how your employer’s coverage affects your subsidy eligibility and what to do if you want a plan other than the one offered through your workplace, do not hesitate to contact Bernardini & Donovan Insurance Services today. Located in Redlands, we are here to help you secure the best protection for you and your family today. Connect with a certified agent; call us today!

When Can I Sign Up for Medicare Part A and Part B?

Of all the government assistance programs out there, people tend to have the most questions about Medicare. It’s true that this government-run health insurance plan can be confusing, because it is so detailed. However, if you just know a few basics about it, it will make learning the rest so much easier.

First of all, you become eligible for Medicare at age 65, regardless of whether or not you are still working or have retired. You can use it in conjunction with your employer-sponsored health insurance while you’re still working, or if you’re able to retain that insurance after you retire. Medicare then acts like a backup insurance plan to cover the things your primary insurance doesn’t cover, such as co-pays. You can also get Medicare if you are legally disabled, regardless of your age.

When you first become eligible for Medicare, you are automatically signed up for Part A. Part A covers hospitalization and all the expenses involved with a hospital trip or stay. Part A is free. You have the option of signing up for Part B when you enroll in Part A, though it’s not required. Part B covers doctor visits, lab work, and any medical work outside of a hospital, except prescriptions. You have to pay a small monthly premium for Part B.

If you don’t sign up for Part B when you first get Medicare, you have the option of signing up for it during the open enrollment period each year. However, the longer you wait, the higher your premium will be, so it’s best to get it right away. Another important thing to remember is that if you’re legally disabled and getting disability payments from the government, you must wait two years after becoming legally disabled before you become eligible for Medicare.

For more information about Medicare in California, please contact Bernardini & Donovan Insurance Services in Redlands!

Are You Eligible for Medicare?

Medicare offers older Americans many health benefits to offset the high cost of medical care. The following guidelines can help you determine if you qualify for what Medicare has to offer.

Individuals age 65 or over qualify for Medicare if:

  • They are U.S. citizens or permanent legal residents and
  • They or their spouse are eligible for Social Security benefits, even if they’re not receiving them yet. (Applicants must have earned at least 40 credits for approximately 10 years of employment)
  • They are government employees or retirees who have paid Medicare taxes during employment
  • Applicants can qualify on their spouse’s employment record if their spouse is 62 and they are 65 or older. This includes a divorced spouse or one who is deceased. Individuals qualifying for Medicare through same sex marriages must live in a state that recognizes this status.

Individuals under 65 qualify for Medicare if:

  • They have been receiving SS disability benefits for 2 years or receive disability benefits from the Railroad Retirement Board
  • They have Lou Gehrig’s disease
  • They suffer from kidney failure and have paid SS taxes for a specific time period.

For more information on Medicare eligibility as a health insurance option in California, contact Bernardini & Donovan Insurance Services located in Redlands, CA.

Costs & Benefits of Medicare Advantage Plans

When considering Medicare Advantage Plans, it helps to take a closer look at their benefits and costs so that you can more easily understand the plans.

As you may know, these plans contract annually with Medicare and a fixed monthly amount gets paid by Medicare. That amount can change yearly, based on Medicare, and varies by county. 

The nice thing about these plans is that they sometimes offer coverage for things that Medicare does not cover. This can include things like eye exams, prescription coverage and dental visits, but it does vary by county.

You should know that there is a monthly premium for these plans and it is in addition to the Medicare Part B premium. 

While some services under these plans require co-payment, they are often at a lower amount than the Medicare fees. And legally the amount is not allowed to exceed the Medicare fee amount.

If you want more information on Medicare Advantage Plans, then contact Bernardini & Donovan Insurance Services today.

Do I Need More Coverage Than The Original Medicare?

If you are approaching the age of 65 and looking forward to enrolling in Medicare for healthcare coverage, be aware that it does not cover everything. Medicare will leave you with things like co-payments, coinsurance and of deductibles. 

Contact a private insurance company right away and learn about Medicare supplements, also known as Medigap. These affordable supplements kick in coverage that the original Medicare doesn’t. If, in your retirement you are looking forward to traveling abroad, you will definitely want a Medigap policy that will provide coverage when you leave the country. 

Medigap supplements are not the same as a Medicare Advantage Plan. You can only have one or the other. Also, you must have Medicare Part A and Part B to have a Medigap policy. You will pay a private insurance company for the policy as well as the Part B premium you pay to Medicare. Additionally, be aware that there are no Medigap policies sold anymore that cover prescription drugs. That ended in 2006. One more reminder, your spouse will need his or her own Medicap policy as each covers only one person. 

For more information about Medicare supplements, contact Bernardini & Donovan Insurance Services serving the Redlands, Island Empire and California residents. 

The Basics of Medicare Advantage Part D Plans

Medicare Advantage Part D plans are a good solution for California residents interested in getting prescription drug coverage to go with regular Medicare coverage.

Also known as Prescription Drug Plans or PDPs, Medicare Part D plans are actually private insurance plans that offer medication coverage. Medicare beneficiaries should note that these plans only offer coverage on eligible prescriptions and not all of them.

Medicare Advantage Part D plans are affordable, with the average monthly premium in California coming in at $58.11 for 2013.

If you have Medicare but do not have prescription drug coverage, remember being without coverage for 63 days or longer can result in a penalty fee.

Since Medicare Advantage Part D plans fall under private insurance, their cost and availability can vary. A qualified insurance agent can help you navigate through the available options to find the most cost effect Part D plan to meet your needs.

For more information about Medicare Advantage Part D Plans in California, contact Bernardini & Donovan Insurance Services today.

What Types of Medicare Advantage Plans are Available?

Medicare Advantage plans are alternatives to traditional fee-for-service Medicare. The plans are sponsored by the federal Medicare program, which pays private health insurance companies to administer and provide coverage to those eligible for Medicare. In other words, Medicare coverage is provided by an insurance company like Humana or United Healthcare rather than directly from the Centers for Medicare and Medicaid Services.

There are several types of Medicare Advantage plans from which to choose:

1. Health Maintenance Organizations or HMOs.

These plans require beneficiaries to select a primary care doctor who manages all healthcare needs. Services from specialists require a referral from the primary care doctor before the plan will pay benefits.

2. Preferred Provider Organizations or PPOs.

These plans include a number of in-network providers who charge a lower co-payment than providers outside the network.

3. Private Fee-for-Service Plans or PFFSs

These plans allow beneficiaries to go to any Medicare-approved doctor or facility, as long as the specific plan is accepted by the provider.

4. Special Needs Plans or SNPs.

These plans are for people with people with certain health conditions or who are living in a nursing home.

To learn more about the Medicare Advantage plans that are available to California residents, please contact Bernardini & Donovan Insurance Services. 

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