Understanding Assignment in the Original Medicare Plan

In the Original Medicare Plan, “assignment” is when you make an agreement between yourself, your healthcare providers, and Medicare.  It can be used to limit the amount of out-of-pocket costs you will be responsible for in your health care.  

How assignment in Medicare works is when you choose health care providers already enrolled in Medicare – and who will accept assignment – you then assign Medicare to pay those health care providers. 

A health care provider who accepts assignment will agree to be paid by Medicare and to accept the Medicare-approved amount for services.  They will also agree to charge you (or your other insurance providers) only the Medicare deductible or coinsurance.   

When a health care provider accepts assignment (and in certain situations, they are required to do so), they need to submit your claim directly to Medicare, and should not charge you for submitting the claim. 

If your health care providers do not agree to accept assignment, they must submit a claim to Medicare but can charge you more than the Medicare-approved amount.  Even if they don’t accept assignment, though, they are usually limited in what they can charge (referred to as a “limiting charge”).  This charge can be up to 15% more than the Medicare-approved amount.  Not all services and supplies have a limiting charge, and sometimes you’ll need to pay for supplies or services before being reimbursed later.  

If you need to find health care providers who accept assignment, an excellent resource is www.medicare.gov.

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