Medicare reimbursements

Posted Friday, May. 09, 2014  comments  Print Reprints

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When I retired from the Marines in 1974, my family and I had Tricare insurance.

Some doctors were reluctant to accept Tricare, saying it was hard to get payment for their services. And Tricare only pays 80 percent, so we needed supplemental insurance.

A change forced retired military to switch to Medicare when they reached 65. Tricare, our healthcare for life, became the secondary insurance.

Now I am having the same problem finding a doctor who will accept Medicare. They tell me to pay upfront, send a bill to Medicare and get reimbursed. My initial visit would be $188 to $400.

I looked at the Medicare and Tricare statements to see how much of the billed charges were paid. Wow! No wonder doctors are not in the system. The payment for the covered charges is almost nil. So even if I pay the initial visit fee of $400, I might only get reimbursed a fraction if anything. Many charges are denied as the procedure is not covered.

Who is the bad guy? Is the doctor overcharging, or the government underpaying?

— Con Shuck, Granbury

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