What might be necessary if a physician does not accept Medicare assignment?

When a physician does not accept Medicare assignment, it means that the physician has opted not to accept the Medicare-approved amount as full payment for their services. In such cases, the patient is often required to pay the entire bill upfront. This happens because Medicare will only reimburse the physician based on its fee schedule, and if the physician does not accept that amount, the patient becomes responsible for the difference between what Medicare pays and what the physician charges.

In addition, what patients should be aware of is that when a doctor does not accept assignment, they also can charge patients up to 15% over the Medicare-approved amount for the services. Therefore, the patient might find the out-of-pocket costs are significantly higher. Consequently, it creates a financial burden as the patient is responsible for the entire amount until they can submit a claim to Medicare for their portion, which may not cover the full cost. This scenario clearly outlines the importance of understanding which providers accept Medicare assignment, as it directly affects the patient's financial responsibilities.