Medicare Frequently Asked Questions

Yes. Medicare requires that we ask a series of questions to determine the insurance with primary responsibility for the claim at each visit. You will need to sign the Consent for Treatment form each time you receive services.

Yes. If you have given us information about your additional health insurance, we will bill that insurance company after Medicare has made their payment.

No. This amount may change depending on your individual insurance coverage. Please wait until you receive a bill from us before making payment.

Medicare covers medically necessary services and certain preventive services. Please visit medicare.gov for specific benefit coverage information.

Advance Beneficiary Notice (ABN), is used to inform you that Medicare may not cover a service because it does not meet their definition of medically necessary. The purpose of the form is to help you make an informed decision.

• For these services, you must be notified in advance that the service will likely not be covered.
• The notice must include what test or services will likely not be covered, as well as an estimate of the cost of those services.
• If you choose to have the test or service, even though Medicare is unlikely to pay for it, you will receive a bill for the service(s) if Medicare does not pay for them.

Because Medicare is unlikely to pay for the service does not mean that you should not receive it. There may be a good reason your provider ordered the service.

The Explanation of Benefits (EOB) form is a document that Medicare sends to you after it has processed your medical claims. The EOB form provides you with information about the payment status of your bill. We recommend you keep the Explanation of Benefits forms you receive from Medicare until your medical claims have been paid in full.

Part A covers inpatient hospitalization and Part B covers outpatient and provider services.

Senior Health Insurance Information Program (SHIIP) is a FREE service that helps Medicare beneficiaries evaluate and better understand their coverage options.

We need information about all of your insurance coverage. Medicare requires us to bill any insurance company that may be responsible before we bill Medicare. We cannot file claims until your other insurance company has determined what they are responsible for paying.

If you enrolled in a Medicare Advantage plan, that plan is responsible for your medical claims. Medicare Advantage Plans are not the same as Medigap plans or Medicare Supplements. Some Medicare Advantage Plans have provider networks and may require you obtain a referral for services.

• For more information on Medicare Advantage plans, refer to Medicare’s “Medicare and You” handbook.
• For information on how your Medicare Advantage Plan works, contact your insurance plan or refer to the Evidence of Coverage supplied by your plan.

Yes. As a Medicare patient, you will be responsible for non-covered charges, co-pays and deductible amounts. These amounts may vary depending on your Medicare coverage. We do not know what your payment may be until we receive the notification from Medicare. Once Medicare lets us know your responsibility, we will bill any other health insurance for the balance. If you do not have other health insurance, you will receive a bill for the balance.

Medicare covers medically necessary services and some preventive services. The preventive services coverage is often dependent on the frequency of the service. For specific benefit information, please refer to Medicare.gov.