Please note that the age limit policy is not intended to discriminate against patients over the age of 59. Tammy has a large population of patients who have already become eligible or are approaching Medicare eligibility. As a small independent privately owned practice, she strives to maintain her relationships with her current patients as they age. If she were to allow all patients over the age of 59 to join her practice, she would have only two choices—disengage services to patients when they become Medicare eligible or close her practice due to an inability to meet operating costs. She appreciates your understanding in her desire to continue to provide care to her patients who have already established a relationship with her practice.