Doctors taking Medicare but not Medigap?

[goillini52]

This was back in the days when UA had no association with Globe.. I think the charge was $2 per month.

I was still selling Globe Med Supps when they told us they started ACF. Shortly after that, Torchmark happened. It pissed me off, because the independent UA agents were allowed to replace Globe Med Supps, but we weren't allowed to replace UA Med Supps. I guess because they knew they were going to merge the Med Supp business under UA because they had a bigger footprint. Everything else(Cancer, HIP, Life, etc) we sold still had the Globe name on it for a year or so.

Our business cards had the Globe Life and the UA and Torchmark logos on them.

P.S. I could've forgotten about that fee for the ACF. Now that you mention $2, it does sound familiar.

 

[yorkriver1]

Medicare physician finder says this . . .
Mayo Clinic - Florida
Charges the Medicare-approved amount (so you pay less out-of-pocket)
Medicare.gov

Which is correct?



Authorization from who? And for what?

Medicare does not pre-authorize anything except DME

Traditional Medicare, in contrast, does not require prior authorization for the vast majority of services, except under limited circumstances, although some think expanding use of prior authorization could help traditional Medicare reduce inappropriate service use and related costs
https://www.kff.org/medicare/issue-brief/prior-authorization-in-medicare-advantage-plans-how-often-is-it-used/#:~:text=Traditional Medicare, in contrast, does,service use and related costs.



It is my understanding they started accepting assignment in 2020 or 21.

This, from the Medicare physician finder, indicates they do accept assignment. The popup balloon (which I cannot copy & paste) says you (the patient) will not be billed for more than the Medicare deductible and coinsurance

Charges the Medicare-approved amount (so you pay less out-of-pocket)

It has been said, probably here, maybe by you, that trying to collect the excess charges may cost more than the extra money from charging them.

 

[yorkriver1]

In theory, yes.. this is accurate. However, Medigap plans are kind of an exception. Namely because if they accept Original Medicare, there's no reason for them to reject the Medigap plan. Medicare makes all claim decisions and the gap plan just pays their portion.

It's why Bob doesn't really *need* to show his card. The insurance company doesn't make any decisions on payouts on claims. Secondly, technically you shouldn't make any payments until you receive your benefits statement, especially in HDG/F situations.

If my doctor opted to really argue me on it, I'd just find a different doctor.

Some medical offices are no longer asking for MedSupp ID cards. They must know that if there is a supplement they will get paid accordingly.

 

[yorkriver1]

Never gave much thought to how the medical provider is notified of the MedSupp payments since they don't have to bill the MedSupp carrier. The medical provider bills after a while eventually show both payments, Medicare & the supplement, then the final balance due if any for MedSupp insured's.

 

[Todd King]

Globe Life and UA were the 1st. Sure saved a lot of time on customer service.

I don't remember a fee. Maybe captives were different.

Oh yeah, they charged for it.