TONI KING: How has Obamacare affected Medicare plans?

This week's Toni Says Medicare column does not have a question because it is my own Medicare adventure. I know Medicare frontwards and backwards, and I am living my own Medicare nightmare.

Not only does one need to know how to navigate the Medicare system, but now you need to know how to navigate getting medical care from a doctor's office, especially when choosing a Medicare Advantage plan.

Both my mother and special-needs sister have had the same Medicare Advantage plan for the past 15 years. I began seeing changes in how the doctor's office is handling their health care after Obamacare started a few years ago. Their primary care physician has to see more patients to make up for the dollars lost from insurance cuts and is not able to spend the one-on-one time that they used to spend with patients.

In June, my sister began having female medical issues and at her age of 60, the medical issues were not normal and required medical testing such as CAT Scan, ultrasounds, etc. to determine if there was a mass, tumor, etc. It has taken over 6 weeks to get the Medicare Advantage HMO referral for a simple gynecological doctor visit, and as of today there is not a diagnosis for Tina's condition.

Now the gynecologist has requested outpatient procedures for biopsies and a simple colonoscopy. Who knows how long these referrals will take to be approved and who knows what gastroenterologist will be used? Since they should put Tina to sleep for a simple female examination, the doctor suggested doing both at the same time because she is having pain in her back.

The doctor's office manager said that Tina's Medicare Advantage HMO Plan is taking more than two weeks to get a referral approved. How does an average senior know how to navigate this type of system? No wonder America's Seniors are so stressed about health care issues.

Below are a few tips about going to the doctor's office to make it easier on those on Medicare, whether you are enrolled in a Medicare Advantage plan or "Original Medicare" with or without a Medicare Supplement:

Many doctors are not accepting "new" patients: After experiencing the delay to schedule an appointment with my sister's primary care physician, I began searching for a new primary care physician for her and my mother. Most of the doctors involved in their Medicare Advantage plan are only accepting "existing patients only."

Toni Says: I would advise anyone who is enrolling in Medicare for the first time to "establish" a relationship with a doctor prior to enrolling in Medicare, whether you are choosing "Original Medicare" with or without a Medicare Supplement or a Medicare Advantage plan.

Many doctor facilities no longer schedule a second appointment to give results: With today's technology, many doctor's offices will email or mail medical results or make a phone call to discuss your medical results. Toni Says: If you need medical information explained, ask to schedule a second appointment whether you are on Original Medicare, Medicare Advantage plan or have an individual health plan.

Search for a 5-Star Medicare Advantage plan to change to during Medicare Lock in: I need to change their Medicare Advantage HMO plan because the network is very limited and referrals take too long.

Toni Says: One can change to a 5-Star plan anytime of the year, not just during Medicare Open Enrollment in the fall.

Toni King, author of the Medicare Survival Guide is on sale at www.tonisays.com. Medicare open enrollment begins Oct. 15, and to have a "Confused about Medicare" workshop at a local church or a company lunch and learn email info@tonisays.com or call 832-519-TONI.