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no name | Is it against the law for doctors office to charge someone with Medicare for a doctors visit? |
I dont know the answer to this, thats why I am asking....My pop has medicare and went to see the doc and he payed 60 dollars up front and my friend said that its against the law, anyways anyone know if it is? |
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sarah314
 |
Given that its January, I'm not surprised that he was charged $60 up front for the visit. Medicare Part B (which is what doctor's office visits fall under) has an annual deductible to meet. That deductible starts from $0 on January 1st of each year.
I'm sure that the doctor's office was assuming that your father hasn't met his Medicare deductible yet, since its so early in the calendar year.
(The Medicare Part B deductible for 2008 is $135. After he meets that deductible for the calendar year, your father will be liable for 20% of the Medicare allowed amount for his office visits. If he has a secondary insurance, it may cover some of the Medicare deductible and/or coinsurance.) |
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src50
|
Your friend is misinformed. |
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heyteach
|
Medicare patients most certainly DO pay for office visits. If he has traditional Medicare, he's responsible for 20% of the bill. If he has a medigap insurance he can try to get them to pay some or all of that--but that's another premium.
If he took out an alternative plan, a Medicare HMO, PPO, or PFFS then he has co-pay. |
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porcelina_68
|
No, it is not illegal. Most Medicare and Medicaid recipients have co-pays. |
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mbrcatz
 |
Even though he has Medicare, he still has a deductible, and he still has copays. And he still has to pay those.
So no, it's not illegal for a doctor to charge. Medicare does NOT mean, you get everything for free. |
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www.podiatricmed.com
|
The patient needs to be aware of the fact that he/she has the ultimate responsibility of paying the doctor fees, regardless.
In this case it is possible that the amount paid was applied to the co-pay that by law the doctor office has to collect up front, or at the termination of that particular visit depending on the specific office policy.
The other possibility is that you father did not meet his deductable for the year.
Some procedures are not paid by Medicare, and ultimately is the responsibility of the patient. |
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ocebse c
|
Medicare Healthcare***I had many questions about Medicare and What is covered under Medicare. I found a useful website www.todaysmedicare.com. This site has tons of medicare information and a Medicare Helpline where I was able to call and talk to a human being. Also Medicare .gov but it is hard to get a quick response there |
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zippythejessi
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Not, it is not illegal. Medicare does not pick up 100% of the tab - there is almost always something that is the patient's responsibility - which is why it's sometimes a good idea to have a Medicare Supplement. (Which is a private insurance that picks up the rest of the tab.)
If a patient has valid MEDICAID (which is different from Medicare. It's supposed to be for low-income people, but there's a lot of abuse of it - but that's another story.) then the provider can not charge the patient - unless the patient has a Medicaid managed care plan that the provider doesn't accept - in which case, the patient is given the option of finding another provider before being seen. |
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Insure Man
 |
Yep, it depends on the plan he has. If he has a traditional Medicare supplement, only Plan J will cover preventive care not covered by Medicare. So most likely, your pop has a co-pay.
http://www.ohioinsureplan.com/index.php/99/most-popular-medicare-supplement-plans/ |
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elaeblue
|
It is medicaid that a person cannot pay for not medicare. |
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tom p
 |
I depends on his plan. Some Medicare/medicaid plans have a deductible or co-payment.
Call Medicare and ask them for a definite answer. |
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