Medicare Assignment

Sunday, May 1, 2005

Assignment is an important word for the Medicare recipient.  It refers to how the health care provider is paid.  If a doctor accepts assignment, the doctor has agreed to always accept the medicare approved amount for each service provided as payment in full.  Since Medicare pays 80% of the Medicare approved amount, that makes the insured responsible for the 20% balance remaining.  All Medicare Supplements will cover the 20% balance after the deductible ($110 in 2005) has been met.  Medicare pays the doctor 80% of the Medicare approved amount directly.   If the insured has a Medigap policy, the Medicare Supplement company then pays the doctor via electronic claims processing the remaining 20%.

If assignment is not accepted, the doctor can charge up to 15% above the Medicare approved amount.  This limiting charge does not apply to all services and supplies.  Medicare Supplements like Plans F and G cover all or most of this excess charge.