Private Contracts and Your Medicare Coverage

Medicare providers must agree to the terms that Medicare sets and be approved through Medicare to provide you service. A private contract is something that you have the right to do, but it is possible that you will not get some of the coverage afforded to you by your Medicare policy. Some things are worth considering before you do this.

• Even if it is a Medicare-covered services you won’t get any money paid to you or the doctor by Medicare.
• The services you get will be paid for in full by you, not Medicare.
• Medigap policies (Medicare Supplement Insurance) will not pay anything for the services that you get either. If you have questions about the service you get before you get it you should call your insurance company.
• The provider that you go to has to tell you that your service may be covered if you go to a facility that accepts Medicare.
• If your provider has been specifically excluded from Medicare they must tell you.

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