By Reg Jones
August 10th, 2012 | Uncategorized
Q. I will retire after age 65. My husband is already older than 65, and we are both covered by my Blue Cross Blue Shield FEHB. I realize I don’t have to make a decision for either of us concerning taking Medicare Part B as long as I’m employed by the federal government. After I retire, I realize BCBS will be constrained by law to pay no more than the Medicare fee schedule amount for services rendered for either of us should I chose not to take Medicare Part B for either of us. Can my doctor require me to pay the difference between the Medicare allowed part my insurance pays and what my doctor wants to charge? Or is my doctor mandated by law to keep fees for services at the Medicare Part B limit regardless of whether my doctor accepts Medicare Part B or not?
A. The answer is on page 24 of your Blue Cross and Blue Shield plan brochure. Physicians who participate in Medicare are permitted to charge only up to the Medicare approved amount. If they don’t participate, they can charge up to 115 percent of the Medicare approved amount. Exactly what is covered depends on whether you are enrolled in the Standard or the Basic option.
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