I Was in a Knife Fight…

The kitchen knife won (I’m boring, have never been in a physical fight with anyone, ever). I required 2 stitches. When having the stitches removed, I discovered a pamphlet/brochure, titled “How We Bill Medicare Patients.” The brochure attempts to explain, and while there are defensible reasons for the limitations, we go through the different handling under Medicare Advantage and Medigap. 

 

Important takeaways:
  • When the clinic is owned by a hospital system (as many are), then there can be two line items, one for the facility, one for the healthcare provider. These are handled differently by Medicare Advantage and Medigap.
  • Most other consumer guides say that Medigap is superior from a coverage point of view. However, that presumes that the Part B deductible has been met under Medigap, which may or may not be true. 
Disclaimer: This is only an example. Your individual situation can differ in important ways.

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