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AARP Medicare Question and Answer Tool
WHAT IS MEDICARE ASSIGNMENT AND HOW DOES IT WORK?
--------------------------------------------------------------------------------
By
Kimberly Lankford,
AARP
Comments
En español
Published September 02, 2022
/ Updated February 09, 2024
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Because Medicare decides how much to pay providers for covered services, if the
provider agrees to the Medicare-approved amount, even if it is less than they
usually charge, they’re accepting assignment.
A doctor who accepts assignment agrees to charge you no more than the amount
Medicare has approved for that service. By comparison, a doctor who participates
in Medicare but doesn’t accept assignment can potentially charge you up to 15
percent more than the Medicare-approved amount.
That’s why it’s important to ask if a provider accepts assignment before you
receive care, even if they accept Medicare patients. If a doctor doesn’t accept
assignment, you will pay more for that physician’s services compared with one
who does.
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HOW MUCH DO I PAY IF MY DOCTOR ACCEPTS ASSIGNMENT?
If your doctor accepts assignment, you will usually pay 20 percent of the
Medicare-approved amount for the service, called coinsurance, after you’ve paid
the annual deductible. Because Medicare Part B covers doctor and outpatient
services, your $240 deductible for Part B in 2024 applies before most coverage
begins.
All providers who accept assignment must submit claims directly to Medicare,
which pays 80 percent of the approved cost for the service and will bill you the
remaining 20 percent. You can get some preventive services and screenings, such
as mammograms and colonoscopies, without paying a deductible or coinsurance if
the provider accepts assignment.
WHAT IF MY DOCTOR DOESN’T ACCEPT ASSIGNMENT?
A doctor who takes Medicare but doesn’t accept assignment can still treat
Medicare patients but won’t always accept the Medicare-approved amount as
payment in full.
This means they can charge you up to a maximum of 15 percent more than Medicare
pays for the service you receive, called “balance billing.” In this case, you’re
responsible for the additional charge, plus the regular 20 percent coinsurance,
as your share of the cost.
How to cover the extra cost? If you have a Medicare supplement policy, better
known as Medigap, it may cover the extra 15 percent, called Medicare Part B
excess charges.
All Medigap policies cover Part B’s 20 percent coinsurance in full or in part.
The F and G policies cover the 15 percent excess charges from doctors who don’t
accept assignment, but Plan F is no longer available to new enrollees, only
those eligible for Medicare before Jan. 1, 2020, even if they haven’t enrolled
in Medicare yet. However, anyone who is enrolled in original Medicare can apply
for Plan G.
Remember that Medigap policies only cover excess charges for doctors who accept
Medicare but don’t accept assignment, and they won’t cover costs for doctors who
opt out of Medicare entirely.
Good to know. A few states limit the amount of excess fees a doctor can charge
Medicare patients. For example, Massachusetts and Ohio prohibit balance billing,
requiring doctors who accept Medicare to take the Medicare-approved amount. New
York limits excess charges to 5 percent over the Medicare-approved amount for
most services, rather than 15 percent.
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ARTICLE CONTINUES AFTER ADVERTISEMENT
HOW DO I FIND DOCTORS WHO ACCEPT ASSIGNMENT?
Before you start working with a new doctor, ask whether he or she accepts
assignment. About 98 percent of providers billing Medicare are participating
providers, which means they accept assignment on all Medicare claims, according
to KFF.
You can get help finding doctors and other providers in your area who accept
assignment by zip code using Medicare’s Physician Compare tool.
Those who accept assignment have this note under the name: “Charges the
Medicare-approved amount (so you pay less out of pocket).” However, not all
doctors who accept assignment are accepting new Medicare patients.
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WHAT DOES IT MEAN IF A DOCTOR OPTS OUT OF MEDICARE?
Doctors who opt out of Medicare can’t bill Medicare for services you receive.
They also aren’t bound by Medicare’s limitations on charges.
In this case, you enter into a private contract with the provider and agree to
pay the full bill. Be aware that neither Medicare nor your Medigap plan will
reimburse you for these charges.
In 2023, only 1 percent of physicians who aren’t pediatricians opted out of the
Medicare program, according to KFF. The percentage is larger for some
specialties — 7.7 percent of psychiatrists and 4.2 percent of plastic and
reconstructive surgeons have opted out of Medicare.
KEEP IN MIND
These rules apply to original Medicare. Other factors determine costs if you
choose to get coverage through a private Medicare Advantage plan. Most Medicare
Advantage plans have provider networks, and they may charge more or not cover
services from out-of-network providers.
Before choosing a Medicare Advantage plan, find out whether your chosen doctor
or provider is covered and identify how much you’ll pay. You can use the
Medicare Plan Finder to compare the Medicare Advantage plans and their
out-of-pocket costs in your area.
Return to Medicare Q&A main page
%{postComment}%
Kimberly Lankford is a contributing writer who covers Medicare and personal
finance. She wrote about insurance, Medicare, retirement and taxes for more than
20 years at Kiplinger’s Personal Finance and has written for The Washington
Post and Boston Globe. She received the personal finance Best in Business award
from the Society of American Business Editors and Writers and the New York State
Society of CPAs’ excellence in financial journalism award for her guide to
Medicare.
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MEMBERS ONLY
Health & Wellness
AARP® Dental Insurance Plan administered by Delta Dental Insurance Company
Dental insurance plans for members and their families
Learn More
See more Health & Wellness offers >
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Health & Wellness
The National Hearing Test
Members can take a free hearing test by phone
Learn More
See more Health & Wellness offers >
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Health & Wellness
AARP® Staying Sharp®
Activities, recipes, challenges and more with full access to AARP Staying Sharp®
Learn More
See more Health & Wellness offers >
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234
*
*
*
*
* Magazines & Resources
AARP Rewards
Learn, earn and redeem points for rewards with our free loyalty program
Learn More
See more Magazines & Resources offers >
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* MEMBERS ONLY
Health & Wellness
AARP® Dental Insurance Plan administered by Delta Dental Insurance Company
Dental insurance plans for members and their families
Learn More
See more Health & Wellness offers >
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* Health & Wellness
The National Hearing Test
Members can take a free hearing test by phone
Learn More
See more Health & Wellness offers >
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* Health & Wellness
AARP® Staying Sharp®
Activities, recipes, challenges and more with full access to AARP Staying
Sharp®
Learn More
See more Health & Wellness offers >
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