Quote:
Originally Posted by Villages Kahuna
What you described is perfectly legal. You aren’t being prevented from seeing your PCP, as a Medicare participant he must see you and treat you. Medicare will pay for 80% of his normal and customary charges. What’s changed is that you must pay for 20% of his charges instead of some form of Medicare supplemental insurance.
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I'm confused. Are you saying that the OP can take advantage of the Original Medicare Part B insurance even though he does not have Medicare Part B insurance? I don't think that is the way it works. The out-of-network doctor may be limited in the amount he can charge the OP, but I don't think the OP can benefit from both Medicare Advantage and Original Medicare at the same time. If he has an Advantage plan (Part C), I don't think he will get the 80 percent Part B reimbursement. He would need to pay the full Medicare amount to the doctor.