Updated on December 26, 2018
How to Lower your Medicare Costs with Assignment
Besides Medicare’s programs that assist people with low incomes and help them pay their plans, and Medicare’s plans like Medigap policies that help you save money, there are other ways in which you can reduce costs when using health care services. One of them is assignment, which can be really useful when going to the doctor. In this article we will explain you how to lower your Medicare costs with assignment.
What is assignment?
Before going to the doctor, you should check if he or she accepts assignment. Accepting assignment means that your doctor (or health care supplier/provider) agreed to accept Medicare-approved amounts as full payment for the services. Sometimes, doctors and health care providers and suppliers are required by law to accept assignment.
What are the benefits of going to a doctor that accepts assignment?
Benefits of going to a doctor that accepts assignment are the following:
- Your out-of-pocket costs will be lower.
- You will be charged only the Medicare deductible and coinsurance amount. You will have to wait until Medicare pays its share before being asked to pay your share.
- Your claim will be directly submitted to Medicare and you won’t be charged for that.
How does assignment work?
Doctors who accept Medicare-approved amounts as full payment for the services are called participating doctors. When you receive a service, Medicare will be charge 80% of it and you will be charged 20%, as part of Part B benefits. This will happen after you pay your annual Part B deductible. In case you are getting a preventive service that Medicare provides for free, like a mammogram, it will be free only if it is provided by a doctor or other qualified health provider that accepts assignment.
What happens if my doctor does not accept assignment?
Doctors who do not accept Medicare-approved amounts as full payment for the services are called non-participating doctors. When you receive a service from this kind of doctors (or health care provider/supplier) you will have to pay an additional charge of 15% above the cost of the service, because that is the charge limit for non-participating doctors. This is called Medicare excess charge. This means that you will have to pay up to 35% of the Medicare-approved amount instead of 20%. This limiting charge only applies to certain services covered by Medicare and does not apply to some supplies and medical equipment. It can also happen that a doctor has opted out Medicare. This is very common as doctor usually change insurance networks. If this is your case, the doctor can charge the amount of money he desires and you will have to pay the entire cost of the services you receive. We suggest to find another doctor if you don’t want to pay for the services on your own.
What happens if I don’t have Original Medicare or I have a Medigap policy?
A Medicare Supplement 2018 policy quote can be obtained by visiting https://www.medisupps.com/medicare-supplement-plans-2019/ The rules mentioned above only apply if you have Original Medicare. In case you have a Medicare Advantage plan instead of Original Medicare, you will have to pay what your plan requires. In case you have a Medigap policy, remember that all Medicare Supplement Plans partially or fully cover Part B copayments, which is the 20% mentioned above, so you won’t have to pay for it and that amount should be charge directly to your Medigap policy. Additionally, there are two Medigap policies that cover excess charges from doctors that do not accept assignment, which is the 15% mentioned above. These are Medicare Supplement Plan F and Medicare Supplement Plan G.
How do I know if a health care provider accepts assignment?
Discovering if your health provider accepts assignment is really simple. You can use Medicare’s tool called “Physician compare”, in which you can search doctors in your area based on if they participate in Medicare or not. You can also simply contact them and ask if they accept it, in case you were considering a particular doctor.