As of April 2010 we dropped out of the Medicare insurance program. We can still see Medicare covered patients, but it is a self pay system. We have developed a model that seems affordable, and has been acceptable to many of our patients as they reach Medicare coverage. It works as follows:
- A signed contract required by the Federal Government every 2 years. This really is a patient protection document that makes clear that patients have a choice of whether to see us vs finding a Medicare participating provider. It does not obligate the patient to see us.
- Retainer Fee, currently $300 a year. This covers administrative costs.
- Cash fee schedule for any service provided in our office. Medicare will pay nothing toward the cost our services. That cost is about the cost of seeing a general dentist.
Importantly, if we refer to another provider or facility (such as a hospital admission or specialist), as long as that provider participates in the Medicare Program there is no penalty. That provider bills Medicare in the usual fashion.
There are ways to reduce out of pocket costs. We can send orders for vaccines and x-rays to free standing facilities that then bill Medicare for services. Blood work drawn in our office is billed by the lab to Medicare in the usual fashion.
If you want to know more, call our office and ask that we mail an information sheet.