Original Medicare

[theinuranceguy]

Ramiz, the answer, as you well know, is painfully simple.

The person who is on Medicare can see any doctor who is not enrolled in Medicare if they are willing to pay the full cost of the visit or procedure.

If the doctor is not enrolled in Medicare and that person still wants to see that doctor the person who is on Medicare can do so by paying the full cost of the doctors services. There is nothing stated anywhere that says the doctor who is not enrolled in Medicare can't charge that person the full cost of the visit or procedure.

In that case it is as though the person does not have any insurance at all. Whether or not the doctor accepts assignment has nothing to do with it.

I have contacted two insurance companies and spoke to their benefits departments and they confirmed the above.

If anyone is telling their clients anything different they are misinforming their clients and could have it come back and bite them in the ass some day.

Lol, Frank you crack me up. No Bull allowed with this guy!

 

[Todd King]

Ok guys, I took the time to go back and for the life of me, it was escaping me what you were trying to say. I kept reading one thing and understanding another. Yes, I know...duh. I was talking about them accept/not accepting assignment from the beginning. The forum (yoos guys) was talking about the doc not accepting medicare at all. Ok, ok i get it.
My statement of the plan F would only be correct if the doctor was just not accepting assignment but was still in the system.
One thing interesting that I did find out though. If a doctor is not in the system, he can not bill medicare or the patient! Unless......unless.......wait for it.....wait.....unless he gets the patient to sign a contract saying the patient is responsible for the full amount. I know, another, well duh! Think about it though...a guy on medicare goes to the doc, the little girl out front doesn't get the guy to sign the responsibility form, doc does his treatment, can't bill medicare, can't bill the patient (well, he can, but the patients not responsible now) , his office just screwed him!

 

[GreenSky]

We accept your apology.

Rick

 

[Guest]

From this thread I'm curious to know if there is a reliable stat on what % of MDs are not part of the Medicare program. I figure most pediatricians would probably not be in the system. Apart from them, I wonder how many docs don't bother with it.

In my area a doc would starve to death if he didn't take Medicare patients with or without assignment. (I live where there are a lot of old people... like ME!)

The Creeper

 

[Frank Stastny]

A plastic surgery, in most cases, would not be covered by Medicare. Therefore, he can charge anything he wants. But if Medicare covered this surgery, then no..he can not charge whatever he wants.

If he is not a Medicare accepting physician, not enrolled in Medicare, he can charge what is usual and customary for his demographics and collect the full amount from the patient who is on Medicare.

It does not matter if Medicare would normally cover the surgery if the doctor was enrolled in Medicare.

If the doctor is not enrolled in Medicare and the patient wants to go to that doctor anyway, the patient will be asked to sign a paper stating that the patient agrees to pay the full amount of the procedure.

Whether or not Medicare would cover it is a mute point. If the doctor is not enrolled in Medicare he/she can charge the full cost of the procedure.

I don't know how else to say it. What part of what I said is not clear? If you believe anything different then you are grossly misinformed.