Medicare Assignment

What Does Medicare Assignment Mean?

Researching Medicare plans and premiums can be overwhelming, and you may come across terms you're not quite sure of. Understanding Medicare assignment will help you determine what your costs will be and which doctors you will be able to see.  Knowing all of your options is important when choosing a Medicare plan in New Jersey.

Medicare Assignment in New Jersey 

Medicare assignment is when your doctor accepts a determined price for Medicare approved medical services, checkups, procedures, and screenings. Doctors that accept Medicare Assignment  agree to the Medicare payment— the payment is "assigned" and non-negotiable. You won't get any surprise bills for this service and will receive statements from Medicare saying how much they paid.

Seeing doctors who accept Medicare assignment can provide you further benefits, including: 

  • Lower costs. Using New Jersey doctors who accept Medicare Assignment can help defray higher medical expenses.
  • You'll be billed any remaining balance after Medicare and any supplemental insurance, pay their portion.  This can reduce your upfront out-of-pocket costs, giving you peace of mind and avoiding budgetary constraints.
  • Your provider will be submitting your insurance claim directly to Medicare, so you won't have to do the legwork - it's all done for you. 

Non-Participating Doctors

Doctors have the option to not accept Medicare assignment but still see Medicare patients.   These doctors are called nonparticipating providers and they can still bill Medicare but may charge up to 15% above the Medicare assigned amount. This cost is called an Excess Charge.  Medicare Supplement plans F and G will pay this Excess Charge, but anyone without those plans could be responsible to pay the charge above the Medicare approved amount.

Doctors that Opt Out of Medicare

Doctors have the option to Opt Out and not accept Medicare.  These doctors should inform you prior to seeing you that they will not bill Medicare.  These doctors can bill whatever they see fit so you should determine the costs for services prior to having any healthcare performed.  You can work out a private payment contract with the provider. 

You can find out which doctors in your New Jersey county accept Medicare assignment by looking them up on Medicare's find and compare website

Contact New Jersey Medicare Brokers today for more information on whether your doctors accept medicare assignment and with any questions about your Medicare coverage.

Not connected with or endorsed by the United States government or the federal Medicare program.