Participating and Non-Participating Medical Providers
What is the difference between Participating and Non-Participating Medical Providers? Participating providers are Physicians and practitioners who register with Medicare as participating providers agree to accept assignment for all of their Medicare patients. Accepting assignment entails two conditions: agreeing to accept Medicare’s fee-schedule amount as payment-in-full for a given service and collecting Medicare’s portion directly from Medicare, rather than the patient. The
Part B Excess Charges
What are excess charges? Medicare beneficiaries may have to pay Medicare Part B excess charges if the receive services form a non-participating provider. A provider that has not signed an agreement to accept assignment for all Medicare -covered services is considered "non-participating." However, these providers can still choose to accept assignment on a case by case basis. Here's what happens if a doctor, provider, or supplier doesn't accept assignment: The Medicare benefi
Enrolling In Part D
Here is how a Medicare beneficiary can get prescription drug coverage. Medicare offers prescription drug coverage to everyone with Medicare. If they decide not to get Medicare drug coverage when they are first eligible, they will likely pay a late enrollment penalty unless one of these applies: They have other creditable prescription drug coverage Or they qualify for the Extra Help program To get Medicare drug coverage, they must join a plan administrated by an insurance comp
Part D Benefits
Trying to understanding Medicare Part D plans can be confusing. If the plan has a deductible, the Medicare beneficiary must pay full price for their drugs until the deductible amount is met and coverage kicks in. “Full price” means the price their plan has negotiated with each drug’s manufacturer. During the Initial coverage period their share of each prescription is either a flat copayment or a percentage of the drug’s cost. Most plans have three or four levels (known as “ti
