Medicare

Part A – Is HOSPITAL coverage only. Patients do not have to pay a monthly premium for Part A benefits if they have worked enough quarters to qualify or if they have a spouse that worked enough quarters. 

Medicare Part A has nothing to do with us.  If a patient has ONLY Part A then they will either be Self-pay or they will have an insurance other than Medicare.  Please scan these cards so that we are aware that patient only had Part A.

Part B- Is Medical coverage

Medicare Part B means the patient will be covered for Ortho services

Patients have to pay a monthly premium for Part B benefits.  Patients can choose to “opt out” of Part B. Usually that occurs when the patient has health insurance through an employer, union or spouse etc. 

 Part C- Is a combination Part A and Part B that is taken over by a commercial insurance carrier and all pre-auth requirements from the commercial insurance are required.  What that means is that the carrier ie BCBS, United, Rocky etc become the Medicare Primary carrier (so when you look at their insurance in ECW you should not see Medicare only BCBS or whatever).  These plans are called Medicare Advantage plans. The cards could indicate Medicare advantage, MA, PFFS, Private Fee For Service or Medicare cost programs. These plans are NOT Supplemental plan they replace Medicare.

Part D- Is the Drug benefit plan that a Medicare person decides to buy to cover drugs.  This plan has nothing to do with us.  Sometime patients will try to give you their Medicare part D card.