Talk of The Villages Florida - View Single Post - Should I switch from Medicare Advantage to regular Medicare?
View Single Post
 
Old 09-24-2024, 06:05 AM
retiredguy123 retiredguy123 is online now
Sage
Join Date: Feb 2016
Posts: 17,496
Thanks: 3,063
Thanked 16,657 Times in 6,588 Posts
Default

Quote:
Originally Posted by HJBeck View Post
I always thought that if an office visit cost $100 and Medicare says the office visit is only worth $50, Medicare will pay 80% of the $50 or $40. Your supplemental plan only pays the balance of what Medicare didn’t pay on the $50 that Medicare said the office visit was worth or $10. The medical provider has to eat the unpaid portion of the original office visit cost.
You are correct.

However, one rare exception is if the provider has totally opted out of Medicare. In that case, the provider can charge whatever they want.