Limits to medical charges for non-Medicare providers


Q: My wife and I are federal retirees and annuitants. We continue to enroll in the CareFirst Blue Cross/Blue Shield standard option. We do not have Medicare Part B. The Blue Cross 2010 Plan Booklet and several explanation of benefits from Blue Cross explain that by law, physicians who do not accept Medicare can only charge us up to 115 percent of what Medicare allows. The law applies to federal retirees and annuitants without Medicare Part B. Please confirm that what I summarized above is correct.

A: What you read on Page 23 of your plan brochure is correct.


About Author

Reg Jones was head of retirement and insurance policy at the Office of Personnel Management. Email your retirement-related questions to

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