What is ‘Medicare Assignment’?
The majority of doctors who accept Medicare insurance also accept medicare assignment. Medicare assignment is a term that refers to the accepted level of reimbursement Medicare is willing to give physicians and healthcare providers for specific medical services or procedures.
If a physician is unwilling to accept medicare assignment, it means that patients may be on the hook for what are known as excess charges. Excess charges are capped at 15% of the approved medicare assignment amount.
An example would be that you go to the doctor and medicare assignment may be $100 for your visit, but your doctor does not accept medicare assignment. Which means he bills for excess charges and can collect up to $115 ($100 + 15% extra).
Does Your Doctor Accepts Medicare Assignment
While many medicare plans cover this excess charge if a doctor does not accept assignment, there are a few that do not. For example, plan N, a standardized medicare supplement plan.
In this case it would be important to know if your doctor participates in medicare assignment.
Search for participating doctors using the Medicare Physician Finder tool.
There have been many strong initiatives for providers to accept medicare, which has caused participation in the medicare program to grow significantly.
If your doctor accepts Medicare insurance but does no file the claim to Medicare for you, they may ask you to pay them the full amount. However, you can be reimbursed for this service by filling out the CMS form 1490S.