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Lower your Medicare costs with Medicare “Assignment.” Assignment means your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved payment amount as full payment for covered services.

YES to assignment…

Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

Here’s what happens if your doctor, provider, or supplier accepts assignment:

• Your out-of-pocket costs may be less.
• They agree to charge you only the medicare deductible and coinsurance amount and usually wait for Medicare to pay its share before asking you to pay your share.
• They have to submit your claim directly to Medicare and can’t charge you for submitting the claim.

Find out if your doctors and other health care providers accept assignment or participate in Medicare. Ask them directly, or find out through www.medicare.gov.

NO to assignment…

Non-participating providers haven’t signed an agreement to accept assignment for all Medicare-covered services, but they can still choose to accept assignment for individual services. These providers are called “non-participating.”

Here’s what happens if your doctor, provider or supplier doesn’t accept assignment:

• You might have to pay the entire charge at the time of service. Your doctor, provider, or supplier is supposed to submit a claim to Medicare for any Medicare-covered services they provide to you.
• They can’t charge you for submitting a claim.
• In some cases, you might have to submit your own claim to Medicare using Form CMS-1940S to get paid back.
• They can charge you more than the Medicare-approved amount, but there’s a limit called “the limiting charge.” The provider can only charge you up to 15% over the amount that non-participating providers are paid. Non-participating providers are paid 95% of the fee schedule amount.

The limiting charge applies only to certain Medicare-covered services and doesn’t apply to some supplies and durable medical equipment. (www.medicare.gov)

Great News! ……. There are some Medicare Supplement Insurance policies that offer coverage for Part B “limiting” or “excess” charges. Give us a call at 1-888-421-6800.

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