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.If you have just gotten Medicare and you want to stay with a doctor who doesn't accept Medicare patients, can you pay the doctor directly and then file a claim with Medicare yourself in order to get reimbursed whatever rate Medicare approves?It turns out this is an increasingly common occurrence when you sign up for Medicare only to learn your all-time favorite doctor doesn’t accept it although 95% do accept Medicare.There are ways to deal with it but you may end up having to pay the entire bill upfront and file a claim using Form CMS-1490S.SOURCE: How to Submit a Claim for Medicare Reimbursement | Boomer BenefitsStay Put and Pay the DifferenceIf your doctor is what’s called a “non-participating provider,” this means he or she hasn’t signed an agreement to accept assignment for all Medicare-covered services but can still choose to accept assignment for individual patients. In other words, your doctor may take Medicare patients but doesn’t agree to Medicare’s reimbursement rates. . .If you choose to stick with your non-participating doctor, you’ll have to pay the difference between the fees and the Medicare reimbursement. Plus, you may have to cough up the entire amount of the bill during your office visit. Then, if you want to get paid back, either your doctor will submit a claim to Medicare or you may have to submit it yourself using Form CMS-1490S.Request a discount [if the physician is an “opt-out provider” and will not accept 15% over medical reimbursement; Medicare will not pay any of the bill.]Use an Urgent Care Center . . .Ask for referral to a physician who accepts Medicare . . .Look for another physician in Medicare’s Physician Compare directory, a comprehensive list of physicians and healthcare providers across the nation. . .What to Do When Your Doctor Doesn't Take MedicareSOURCE: Do All Doctors Accept Medicare Supplement Plans? What if They Don’tSOURCE: Paying a Visit to the Doctor: Current Financial Protections for Medicare Patients When Receiving Physician Services

If you're talking about getting there after a foreign obtained MBBS, then the one way to get there is en route to residency. This is what I know best based on a few of my friends who have got into the US.We are International Medical Graduates (IMGs). IMGs must pass Step 1 and Step 2 of the United States Medical Licensing Examination (USMLE), which are the same examinations taken by the American grad students. These exams matter. So they should be done well. They give you an edge. Also, research and US clinical experience in the form of clerkships and all help, I've been told.Pass Step 1 of the USMLE. (Refer website below for info regarding these exams.)Pass Step 2, clinical knowledge, of the USMLE.Pass Step 2, clinical skills, of the USMLEIf needed, pass Step 3. Moreover, this increases your chances of getting an H1B visa and anyway most programs mandate that it be completed by the end of tmyour first year in residency.Requirements needed to obtain an ECFMG certificate.Your Medical school should be listed in the World Directory of Medical Schools. (In India, we call the same as a medical college.)IMGs are awarded credit for at least four years of medical school. Most, MBBS curriculums are designed to incorporate more than four years, so chill.Documents include the final medical diploma, we call this our MBBS degree and the final rotating internship certificate and also Final medical school transcripts, which are the university exam certificates from all years. At least, that's what I've been given to understand.6. After you're done with all this and assume you have some US clinical experience or research experience, you can apply to various programmes. Since Harvard seems to be your first preference you can apply there first. Assume at this stage, the program director and the relevant staff like you, they give you a call for an interview. Otherwise, you're left with your other choices.7. If you do get a call and ace the interview, you stand a chance of getting matched. Congrats then, you're one of those few who beat the process.(But, who knows you'd match into a sufficiently better program elsewhere.)Hope this flow chart makes sense.On a much realistic level, Havard is reasonably competive for the U.S graduates themselves, so getting a residency position in Harvard as an IMG is frankly way, way difficult. You need impeccable scores and adequate research and clinical experience. My friend told me that his American colleague didn't get in there even with 6 months of a clerkship, a stunning score and research experience. But, that may have been an isolated incident as neurosurgery is indeed of a cutthroat competition.Mass Gen hospital and others are known affiliates of the Harvard education system. It's still competitive. But, who knows you could be those few.Credits: A recently matched physician doing his internal medicine residency at another reputed hospital. His experience along with a few more were mainly the basis of whatever I've said. I'm also learning the process. Shared whatever I know.(Sorry, other than medical residency applications there may be other opportunities post MBBS, none of which I'm quite sure about. I just know that this is the rough sketch of the process.)Additional information.ECFMG | CertificationHow the Certification Process Workshttps://www.martinus.edu/residency/United States Medical Licensing Examination, regarding the exams. And Fees and PaymentHMS Harvard website.Hope I was of help! Thanks.

Tapering very slowly is the best way to reduce or discontinue antidepressants. This is because they cause physical dependence and withdrawal---even a single dose of an antidepressant changes your brain in physical and functional ways.Not everyone can avoid withdrawal symptoms, even at ultra-low tapering amounts, but usually you can smooth out your ride some by instituting a much slower and less drastic taper. If your pain or debilitation is too great after reducing your dose, you can reinstate the dose you were taking just previously to try and restabilize your system. Reinstatement does not always work for people who are in withdrawal (and can make things even worse for some people, especially if they wait a while before reinstating), but it can be live-saving in some cases.Quitting cold turkey is a terrible idea and can cause disability, hospitalization, or even death. It can take months or years to taper at an appropriate rate that does not leave you quite debilitated, but the severity of withdrawal symptoms varies from person to person and some individuals have an easier time tapering or withdrawing.Following are some notes and resources which may help you taper and withdraw. This is neither comprehensive nor meant as a how-to guide---I am not qualified to write that, and I advise looking around the internet for comparing and contrasting resources that will help you find what works best for your own tapering.Tapering Resources:The best online collection of tapering information I have come across is located here: Important topics in the Tapering forum and FAQ - Tapering It is a community-based website that specializes in dealing with the problems patients encounter when discontinuing their psychotropic medications. They explore and share personal and scientific sources for how to best taper and cope with the complications of trying to quit antidepressants and other brain-altering drugs.There is also information there about supplements and alternative therapies, but such things are not to be taken lightly or experimented with if you are in a state of hypersensitivity due to withdrawal. You can read about supplements and other substances here: Important topics about tests, supplements, treatments, diet - Symptoms and self-care And about non-drug methods of healing and recovery here: Non-drug techniques to cope with emotional symptoms - Symptoms and self-careProfessional Assistance:Definitely speak with your prescribing doctor on how to most safely discontinue your medication (and about any supplements or alternative therapies you are considering), but understand that most doctors--even psychiatrists--are not very well educated about the dangers of their medications and the slower tapering speeds that many people require in order to remain at least partly functional. Try searching for a doctor who is experienced and interested in helping you taper and discontinue antidepressants if you can manage to find someone and afford to be seeing him.There is a partial multi-site directory of such doctors here: Recommended doctors, therapists, or clinics - Tapering, but finding someone mostly consists of calling physicians (psychiatrists, addiction specialists, experts in practiced psychopharmacology, etc) until you find someone who has the required expertise. They are quite rare, unfortunately, so do not stake your ability to safely reduce antidepressants on finding the right doctor.About Professional Advice:If you fall into a state of disabling withdrawal due to your antidepressant taper, most doctors (even psychiatrists) may reject your symptoms, refuse to treat you, or attempt to proceed with misguided methods of treatment which can cause further harm to you. Finding a safe practitioner, if you see one at all, is even more important in those instances, if you can manage it.Do not accept the suggestion of taking more drugs or different drugs as a means of alleviating your withdrawal symptoms. In the minority of cases, people find them helpful as an aid, but most of the time they cause more harm, more complication, and more withdrawal. Benzodiazepines, anticholinergics, and antidepressants with longer half-lives are not a cure for dependency or withdrawal, and they are psychoactive agents which can cause all the same symptoms and damages as you are trying to avoid in tapering off your current antidepressant. Whether or not you choose to try them is up to you, but it is important to understand that they are not a fix or a cure.Seeking Additional Help:Supplementing your taper with a side effect-educated psychotherapist, high quality outpatient drug rehabilitation expert, or other form or healthcare professional can sometimes reduce the strain and danger of lacking a good psychiatric resource, which is the position most tapering patients find themselves in. I highly recommend having a professional network in place if you plan to taper or discontinue, especially because your ability to establish it may be diminished by your efforts to be free of drug dependence. Having a pain counselor or someone to discuss iatrogenic harm or practical difficulties with can be enormously beneficial even if you are not suffering from psychological withdrawal symptoms.There are some websites, scientific articles, and support groups online that you can look to for advice and encouragement during withdrawal and post-medication healing. Places like SurvivingAntidepressants (Surviving Antidepressants), MadInAmerica (Mad In America - Science, Psychiatry & Community), RxISK (Prescription Drugs, Side Effects, Interactions), SSRI Stores (SSRI Stories | Antidepressant Nightmares) Beyond Meds (Beyond Meds), and the websites and resources of psychiatrists, doctors, and researchers dedicated to dealing with the issue of psychotropic drug damages and withdrawal syndrome---people like Dr. Joseph Glenmullen, Dr. Peter Breggin, Dr. David Healy, Dr. Stuart Shipko, Dr. Kelly Brogan, and a few dozen publishing scientists.You can read articles, posts, and books on the subject of successfully quitting antidepressants, as well. To start you off, here is a psychiatrist-written guide to stopping antidepressants, a brief post which outlines some steps you might find important, a free book (in pdf format) about reducing the risks of discontinuing psychiatric drugs, and a Quora post I made about recovering from the changes medications can cause in our brains and bodies:Guide to Stopping Antidepressants6 Ways to Prepare for Withdrawal from an Antidepressanthttp://www.willhall.net/files/ComingOffPsychDrugsHarmReductGuide2Edonline.pdfMarcus William's answer to How can one reverse brain damage from drugs?