What doctors take?

Almost all doctors take Medicare and all Hospitals do. Does that mean that if they take Medicare they will take your supplement? The answer is yes! Most folks that have been on managed care their entire lives think that the private insurance carrier, the supplement dictates their care. This simply is not true. Medicare is the primary insurance coverage that you will have. Meaning as long as the provider takes Medicare they will automatically take the supplement. No matter what carrier.

How does this work?

When you see a doctor they will submit a claim on your behalf to get paid. The claim goes to your primary insurance which is Medicare. Medicare generally pays 80% for services. If the service is over 80% and you have a supplemental plan that works in conjunction with Medicare then the supplement will pay. Let’s go a little deeper. Medicare will reach out to the private insurance carrier that offers you coverage. Medicare will ask for the additional funds that Medicare will not pay for. The private insurance carrier is obligated by contract to pay when asks by Medicare. The private insurance carrier which provides you the supplement will pay Medicare. The doctor will get paid by Medicare and some of that money will be from the private insurance carrier. The providers office most likely is not contracted with the supplement carrier you have. All their money will come from Medicare.

Education

Unfortunately there can be a lot of confusion when it comes to speaking with your providers front desk. When they ask what coverage you have if you say, ” I have Aetna.” The office might think that you have a Medicare Advantage plan. That office might not contract with that carrier. They may tell you that they do not accept that coverage. This usually leads to a tailspin of confusion. Simply put when asked to present your insurance just give them your Medicare card along with your supplement card.