Posted on Thursday, April 7, 2022
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by AMAC Medicare Advisory Service
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9 Comments
Don’t get caught paying in full for covered Medicare services – be sure your doctor accepts Medicare assignment. Check out this week’s tip to find out more!
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15% more? Where do you get your info? Medicare’s assignment prices are a TINY FRACTION of the “regular price” and the rest of us, who aren’t Medicare eligible, are paying those huge prices to make up for Medicare. It’s far more than 15% over.
After Trump elected & billing transparency happened, I went to the ER. We got a detailed bill from the hospital & I was able to see who got paid & what. Med b paid, the gap paid & I knew exactly what I owed. My husband had a very recent trip to the ER. We’ve never received a bill. Med b paid & the gap paid, but we still don’t know the amount billed or the total med b paid on. the med b eob is impossible to decipher without a bill. we’ve gotten a couple of bills but unable to determine what we really owe.
Sometimes this is not clearly stated upfront by both Medicare and your designated doctor. I just recently had a colonoscopy ( a covered procedure) which was deemed necessary this year because of a result from the home fecal test (Coligard). I was told that I was fully covered for the procedure by my insurance ( Aetna Medicare) but I had to cover my copayment. Based on the description, I had a copayment of $45 ( specialist) and $395 for the visit. Nothing was mentioned on any coverage cost for the anesthesiologist, despite repeated requests. I paid out of pocket $1000 plus the full cost of the prep materials which are required by prescription, and additional $250. These costs are considered part of the deductible out of pocket costs beyond your premium costs. I pay my Medicare premium so I don’t get it free because my retirement income is just above the “poverty level”.
They tell us to ask for transparency for all cost for medical services but fail to explain how they come up the cost we have to pay without explaining why we have to pay an out of pocket costs. A covered cost should not have any out of pocket costs beyond what is stated. Especially when dealing with a doctor who accepts your insurance and your insurance accepts the doctor
Good advise. For example, I recently got medical care from a doctor who accepted assignment from Medicare. (I have original Medicare Parts A & B.)
The billed amount was $814.00. Medicare approved $188.32.
Medicare paid 80% of the approved amount ($150.66); I paid my 20% of the approved amount ($37.66), and since the doctor accepted assignment from Medicare, the doctor considered the bill paid in full.