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US Medicare Medigap Question
#1
I was under the impression that if a provider accepted payment from Medicare, they could not charge more than Medicare assignment. To do so would be an illegal "up-charge."

I guess I was wrong. I'm comparing a plan C medigap to a plan F medigap. The F plan pays excess charges. It would seem a provider can accept medicare + the 20% paid by my medigap plus ask for up to 15% in excess fees.

Am I reading the fine print correctly?
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#2
Nope. If the DME accepts Medicare, and you have traditional Medicare, they accept assignment. You are responsible for 20%. If your medigap plan is covering the 20%, then you owe nothing. There is no 15%. They are scamming you.

I know nothing of Medicare Advantage Care plans. After my godmother got screwed by an Advantage plan, I chose to stick with traditional Medicare (The plan closed up mid-year while she was getting treatment - she was left with NO coverage at all until the next open period).
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#3
I stay with traditional Medicare and have an HRA account that my former employer puts money into for me to buy coverage. So, I buy a Medigap plan and Part D. Advantage plans are HMOs; an I'd have to use their doctors. I'll keep the one's I have.

As for you GM's situation, I thought loss of coverage due to the dissolution of a plan meant one could enroll in another plan out of the annual enrollment period.
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#4
(11-14-2015, 12:25 PM)justMongo Wrote: I stay with traditional Medicare and have an HRA account that my former employer puts money into for me to buy coverage. So, I buy a Medigap plan and Part D. Advantage plans are HMOs; an I'd have to use their doctors. I'll keep the one's I have.

As for you GM's situation, I thought loss of coverage due to the dissolution of a plan meant one could enroll in another plan out of the annual enrollment period.

Yes, but there was a gap of about 2 months between when she was notified of no coverage and coverage under a traditional Medicare plan.

I also went with traditional Medicare only because I kept getting sent to specialists and some were in-network, some not. Pretty much everybody is in-network for the BCBS senior plan.
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#5
Yep. As Skeeterbait said...Traditional Medicare will pay 80% of the "allowable" amount, if the "provider" has agreed to accept Medicare. You or your Medigap will be assessed the 20% remainder. There should not be any additional 15% of anything. The provider can submit a charge of any amount that they want but is required to accept the Medicare or Medicare Plan Allowance.
Yesterday is history; Tomorrow is a mystery; Today is a gift; Thats why its called "The Present".
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#6
I have a PLAN F Medigap policy and it covers everything. Never had any additional charges.

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