Finding a Rheumatologist Near You Who Accepts Medicare

Christian Worstell
In this article...
  • Pain and swelling in your joints may be a sign that you have rheumatic disease. Read on to learn how to locate a rheumatologist near you who accepts Medicare.

If you have pain or tenderness in your joints and bones, you may have a rheumatic disease such as arthritis. These conditions can be painful and debilitating, causing stiffness and swelling that makes it hard to use your hands, climb stairs or walk.

Learn more about the symptoms of rheumatic disease, when you should see a specialist and how to find a rheumatologist near you that accepts Medicare.

How to Find a Rheumatologist Near You Who Accepts Medicare

There are several ways to find a rheumatologist near you who accepts Medicare.

  • Use Medicare's online physician search tool 
  • Ask your private health plan carrier
  • Ask your primary care physician

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Getting Ready for Your Rheumatologist Appointment

Once you've found a rheumatologist near you who accepts Medicare, begin preparing for your appointment. It's helpful to bring medical information related to your condition, including:

  • Previous X-rays, ultrasounds and tests
  • Medications you're currently taking, including dosages
  • Medications you've previously taken for this condition, if any
  • List of allergies
  • List of family members with a history of rheumatic and autoimmune diseases

Your rheumatologist may order additional tests to look for signs of inflammation or musculoskeletal abnormalities.

What's a Rheumatic Disease?

Rheumatic disease is a broad category of musculoskeletal, autoimmune and inflammatory conditions. There are more than 100 rheumatic diseases which affect:

  • Joints
  • Tendons
  • Ligaments
  • Bones
  • Muscles
  • Connective tissues
  • Internal organs

These diseases cause swelling, pain and stiffness. Some common examples of rheumatic diseases include:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Gout
  • Lupus
  • Tendinitis
  • Bursitis
  • Fibromyalgia

Difference Between Arthritis and Rheumatic Disease

About 54 million Americans have arthritis, a type of rheumatic disease that specifically affects the joints. By 2040, arthritis is expected to affect 78.4 million people, or more than one-quarter of the adult population in the United States. Arthritis commonly occurs with diabetes, cardiovascular disease and obesity.

Should You See a Rheumatologist?

The American College of Rheumatology suggests consulting your primary care doctor if you have any signs of rheumatic disease. While these symptoms vary depending on the specific disease, common signs to watch for include:

  • Pain, swelling or inflammation in your muscles, bones and joints (including the wrist, elbow, knees, hands and feet)

  • Joint stiffness lasting at least one hour beginning in the early morning
  • Joint pain or tenderness
  • Joints that are inflamed, red or warm to the touch
  • Severe discomfort that lasts more than three or four days

It's important to consult a physician in a timely manner if you're concerned, especially if:

  • You have a family history of autoimmune or rheumatic diseases
  • Your symptoms get worse quickly
  • Your symptoms improve with treatment but return once you stop the medication

Rheumatic diseases can cause progressive and long-term damage to your organs and joints if not treated early. A study cited by the American College of Rheumatology notes that patients treated within 12 weeks of onset of the disease experience about 30% less pain after three years than patients treated after 12 weeks of onset.

Your primary care doctor may decide to refer you to a rheumatologist for diagnosis and treatment.

What Does a Rheumatologist Do?

A rheumatologist is a physician with advanced training in diagnosing and treating rheumatic disease. To become a rheumatologist, a doctor must complete:

  • Four years of medical training
  • Three years of residency training in internal medicine or pediatrics
  • Two or three years of a rheumatology fellowship focusing on chronic musculoskeletal and autoimmune conditions
  • A board examination for certification
  • Annual continuing education requirements to keep knowledge and skills current

Do You Need a Referral to See a Rheumatologist?

In most cases, if you have health coverage through Original Medicare, you may see any physician you wish without a referral as long as they're enrolled in Medicare.

If you have Medicare Advantage, your plan may require a referral from your primary care physician. You may also need to see an in-network rheumatologist for the plan to cover the costs. Consult your plan for more details.

Treating a Rheumatic Disease 

If you're diagnosed with a rheumatic disease, a rheumatologist can develop a treatment plan to relieve your symptoms. There’s no cure for these conditions, but a combination of medication, physical therapy, exercise and diet can help to manage your symptoms and slow the disease's progression. In some cases, surgery may be recommended.

Christian Worstell
About the Author

Christian Worstell is a senior Medicare and health insurance writer with HelpAdivsor.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

While at HelpAdvisor, Christian has written hundreds of articles that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. You can find Christian’s most recent articles in our blog.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@MyHelpAdvisor.com.

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