Medicare Blog

what if bcbsfep with medicare visits doctor does not accept medicare

by Kavon Ryan I Published 2 years ago Updated 1 year ago

As long as your current doctor accepts Medicare, you should be able to see them and receive coverage for the visit. However, if they decide not to accept Medicare or stop participating in the program, you will need to find another doctor.

Full Answer

Why do doctors charge Medicare and BCBS at the same time?

When you have medicare plus a secondary insurance, medicare still insists that the docs charge the medicare rate. Your doctor can't charge you the normal rate he charges, have medicare pay their portion and have BC/BS pay the rest. By law, if you have medicare coverage and they accept you as a patient, they HAVE to charge the medicare rate.

What happens if I choose a doctor who accepts Medicare?

If you choose a doctor who accepts Medicare, you won't be charged more than the Medicare-approved amount for covered services. A doctor can be a Medicare-enrolled provider, a non-participating provider, or an opt-out provider. Your doctor's Medicare status determines how much Medicare covers and your options for finding lower costs.

Do you pay for your doctor with Medicare or Blue Cross?

Then can you just go ahead after you see the doctor, pay them yourself, and then submit the bill along with the Medicare form, and possibly see some reimbursement from Medicare, and some from your secondary carrier, which in my case happens to be Blue Cross Standard. Medicare is primary for me, since I am retired.

Can doctors refuse to accept Medicare?

Can Doctors Refuse Medicare? The short answer is "yes." Thanks to the federal program's low reimbursement rates, stringent rules, and grueling paperwork process, many doctors are refusing to accept Medicare's payment for services.

Does FEP follow Medicare guidelines?

Use Your Benefits If you decide to combine your Medicare and Service Benefit Plan coverage, we'll pay for covered services not covered by Medicare.

How Medicare works with FEHB plans?

Since you are retired but covered under your working spouse's policy, your spouse's policy is your primary coverage. Medicare will pay secondary benefits and your FEHB plan will pay third.

Do feds need Medicare when they already have FEHB?

The answer: yes! FEHB coverage is comparable to Medicare coverage. Therefore, beneficiaries in the federal program may delay joining a Part D plan; likewise, they're exempt from any Part D late enrollment penalties. The federal employee plans often include prescription drug benefits, although drug coverage may vary.

Is FEHB creditable for Medicare?

Federal Employee Health Benefits (FEHB) prescription drug coverage is creditable for Medicare-eligible retirees.

Do federal employees have to take Medicare Part B?

You don't have to take Part B coverage if you don't want it, and your FEHB plan can't require you to take it. There are some advantages to enrolling in Part B: You must be enrolled in Parts A and B to join a Medicare Advantage plan.

Do most federal retirees take Medicare Part B?

About 70% of federal retirees enroll in Part B, which means paying two premiums and in essence two duplicative insurance programs. A portion of the retirees that join Part B might do so as a hedge against the elimination of FEHB retiree benefits.

Is Medicare primary or secondary to FEHB?

primary payerGenerally, if you have Medicare and you (1) are age 65 or older and (2) are not employed in the federal service, Medicare is the primary payer of your health benefits expenses, and your FEHB plan is the secondary payer.

What does Medicare Part B cover that FEHB does not?

Medicare may cover some services and supplies that some FEHB plans may not cover, including but not limited to: • Some orthopedic and prosthetic devices, and durable medical equipment; • home health care; • limited chiropractic supplies.

Do federal retirees need Medicare Part B FEHB?

Unlike most people with retiree coverage, who must enroll in Medicare Part A and Part B when they're first eligible, enrollment in Medicare is not mandatory if you have federal retiree coverage through the Federal Employee Health Benefits Program (FEHB).

Is Medicare Advantage better than FEHB?

Most MA plans are comparable to FEHB plans in hospital and medical benefits, but the prescription drug benefits will not be as good as in the FEHB program because the plans have a “coverage gap” where you are responsible for all or most drug costs until you reach a catastrophic limit.

Can Medicare premiums be deducted from federal pension?

Frequently Asked Questions Retirement If you are not receiving social security benefits, you can have Medicare premiums withheld from your annuity payments. We must receive a request for the withholding from the Centers for Medicare and Medicaid Services.

What is the most popular FEHB plan?

The rankings were released as part of the 2020 FEHB Plan Performance Assessment, which rates 83 health plans across the country in the areas of quality and customer satisfaction. “I could not be any more proud that CDPHP has been named the preeminent health plan in the country for federal employee health benefits.

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