Providers that do now accept assignment with Medicare can bill you up to 15% above what Medicare allows. That still doesn’t make up for the 21% decrease that Medicare allows for providers that went into effect last March 1st.
now = not
Doctors who accept assignment must accept what Medicare allows. Medicare pays the doctor 80% of the allowed amount and the doctor must collect the 20% balance from the patient. Doctors who do NOT accept assignment are allowed to charge 115% of the allowed Medicare amount, but gets nothing directly from Medicare, and has to collect the entire amount from the patient. The patient is reimbursed from Medicare the 80% of the allowed amount, and may or may not pay it (along with the 35% balance owed) to the physician. That is why most physicians accept assignment. They are guaranteed at least 80% of the allowed charge. Usually the allowed charge is about 75% of the regular charge and the physician gets paid significantly less than from insurance companies. For example, an insurance company may pay $90 on a $100 charge. Medicare allows $75 and pays the doctor accepting assignment $60 and the doctor may or may not be successful in collecting the other $15 from the patient. This is why almost 40% of doctors no longer accept new Medicare patients.
As for myself, I planned to retire in 4 years, but if Obamacare passes, I will retire immediately. There are many doctors out there much younger than myself who can go into a variety of non-clinical medical professions or even non-medical fields. I read recently of a physician who made significantly more selling clothing on ebay than she made seeing patients. There are many entrepenurial opportunites for bright motivated people, and I would not be surprised to see a mass exodus of physicians if Obamacare passes.
As for the March 1 21% decrease, we have been granted a stay of execution until October 1, when it will take place, unless congress passes something to the contrary.
John Galt is alive and well.