We’ve been exploring aspects of Medicare on the blog, beginning with some key words people should understand and continuing with Part A and Part B.
Another way to look at Medicare Part B coverage is that it covers the day to day, routine health care that a retiree needs.Therefore, it is more like the individual coverage or employer-based coverage you had before retirement, and far less costly.
Difference With Medicare Over Your Insurance
There is at least one very important difference, though, between Medicare Part B and the insurance you had when working. You may already have encountered it when trying to use Medicare in general for your health care needs.
The issue is the amount the government pays a health care provider to furnish the services. You see, a provider is under no obligation to participate in the Medicare program, although a great many do. In fact, many providers base a large part of their practices on Medicare patients.
In contrast, the private insurance company that issued the policy or was behind the managed care program you had while working negotiated with doctors, hospitals, groups of doctors, and groups of hospitals as to reimbursement rates. Those rates of payment were often higher than what Medicare pays.
Therefore, when a provider tells you that he/she is not accepting any more Medicare patients, it may be because the provider needs to limit the number of patients that he/she sees at the lower reimbursement rate. This is especially true because Medicare often requires the provider to submit a great deal of paperwork in order to be paid.
There is more to Medicare than just the government established system.
Further, you have other options by which to effectively handle your health care needs. These can involve insurance products from the private insurance market, as well as non-insurance methods.
About The Author
Luke Brown is a retired lawyer in the area of insurance law (in Florida for 30 years). His current project is Your Problem Solvers which assists others in understanding, prioritizing, and managing life’s daily challenges including insurance issues, healthcare, dealing with government and corporate bureaucracies, deciphering medical billing issues, and helping with general explanations of legal principles. Reach Luke at firstname.lastname@example.org or on his Facebook page.