Q. I have just retired from federal government (age 67) and have Blue Cross/Blue Shield insurance. I signed up for Medicare Part A at 65, and am trying to decide whether to sign up for Part B. (I gather I have eight months from time of retirement.)
I gather many doctors do not take Medicare, but if they do, I understand that they are governed by Medicare rules and payment schedules, whether or not the patient has signed up for Medicare. Is this correct?
I have read that the insurance company cannot pay more than the Medicare payment schedule allows, but if Medicare does not cover a procedure and the doctor/facility participates in Medicare, is the doctor allowed to provide the service and, if so, will BC/BS, as primary insurer, be able and willing to pay if Medicare would not?
If neither the doctor nor the patient is enrolled in Medicare, will BC/BS, as primary insurer, provide any coverage?
A. You don’t have eight months after you retire to elect Medicare Part B.
Instead, there is a seven-month enrollment period, which begins three months before you turn 65 and ends three months after that month. If you don’t sign up within that time frame, the premiums increase.
Even if a doctor doesn’t take Medicare, he is governed by Medicare’s payment limits, which are somewhat higher than those that they pay doctors who do accept Medicare. If Medicare doesn’t pay for a benefit and your Federal Employees Health Benefits plan does, the amount they cover will be governed by their rules. You’ll have to check your plan brochure to see what those are.
