If you have original Medicare, the doctor you visit can make a difference in how much you have to pay. While you can go to any doctor who accepts Medicare payments, if the doctor does not “accept assignment,” you can end up paying a lot more. (This does not apply to beneficiaries who are in Medicare Advantage, or managed care, plans.)
Medicare Part B recipients must satisfy an annual deductible. Once the deductible has been met, Medicare pays 80 percent of what Medicare considers a “reasonable charge” for the item or service. The beneficiary is responsible for the other 20 percent.
However, in most cases what Medicare calls a “reasonable charge” is less than what a doctor or other medical provider normally charges for a service. Whether a Medicare beneficiary must pay part of the difference between the Medicare-approved charge and the provider’s normal charge depends on whether or not the provider has agreed to participate in the Medicare program.
If your doctor participates in Medicare it means that the doctor “accepts assignment.” In other words, the doctor agrees that the total charge for the covered service will be the amount approved by Medicare. Medicare then pays the provider 80 percent of its approved amount, after subtracting any part of your annual deductible that has not already been met. The provider then charges you the remaining 20 percent of the approved “reasonable” charge, plus any part of the deductible that has not been satisfied.
If your doctor does not participate in Medicare and does not accept assignment, the rules are different. Non-participating doctors can charge 20 percent of the approved amount plus up to an additional 15 percent more than the Medicare-approved amount. Non-participating doctors can also charge you for the care upfront and request that you bill Medicare, while doctors who accept assignment cannot.
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The real problem in America is not the Government – it is us. Why? We are the ones who want the government to cut the deficit without touching Social Security, Medicare or taxes. Who is kidding who? We need to get real. When commentators speak of American ingenuity and resilience they speak of the capacity to intelligently make decisions even in the face of personal sacrifice (I think!). Neither of our two political parties is being honest about the solutions – but we (the voters) can do better. The politicians have their finger in the wind to navigate their actions. If we the voters would be honest and reach out to our legislators with honest opinions they too would change.