What’s The Difference Between a Doctor “Accepting Medicare” or accepting “Medicare Assignment”?

It’s important to know that not all doctors bill the same way. Some doctors accept “Medicare Assignment” and agree to the rates Medicare sets and takes those amounts as full payment. Other doctors participate in the Medicare program but do not accept Medicare Assignment.

Accepting Medicare Assignment

Doctors who accept Medicare Assignment agree to be paid by Medicare. They submit the claim to Medicare and agree to accept the Medicare-approved dollar amount for a procedure. They can’t charge you more than that amount. You will still be responsible for dedcuctibles, co-pays and coinsurance (often 20%), but your share is limited by what Medicare pays.

Not Accepting Assignment

Some doctors participate in the Medicare program but do not agree to accept Medicare Assignment. Under the rules of Medicare Part B, doctors are allowed to charge you a an additional 15%, on top of the 20% you are already responsible for, if they accept Medicare, but not Medicare Assignment.  These are referred to as “excess charges”.  So in reality, you would be responsible for 35% of the bill, instead of 20%.  When looking at Medicare Supplements, be sure to check if your plan will pay these “Excess Charges” or not.

The best way to find out whether or not your doctor accepts Medicare Assignment is to call the doctor’s office directly.. Continue reading