Insurance & Frequently Asked Questions

Insurance (Medicare)

We are happy to care for patients who have Medicare.

• Medicare Accepted: We accept Original Medicare (Part B) for services that meet Medicare’s coverage rules.
• Medical Necessity: Medicare only covers services that are medically necessary and properly documented.
• Medicare Advantage Plans: Coverage with Medicare Advantage (Part C) plans depends on your specific plan. Referrals or prior approval may be required.
• Supplemental Insurance: If you have a Medigap (supplemental) plan, it may help pay costs that Medicare does not fully cover.
• Out-of-Pocket Costs: You may be responsible for deductibles, coinsurance, or services Medicare does not cover.
• Non-Covered Services: If a service is not covered by Medicare, you will be informed before receiving care and given self-pay options.

Coverage decisions are made by Medicare or your insurance plan, not by our office.

Do you accept Medicare?
Yes. We accept Original Medicare (Part B) for covered services. We also work with some Medicare Advantage plans.

What does Medicare pay for?
Medicare pays for services that are medically necessary and meet its guidelines. Coverage depends on your diagnosis, service type, and frequency.

Will I have to pay anything?
You may have costs such as a deductible or coinsurance, unless you have supplemental insurance that covers them.

Do I need a doctor’s order or referral?
Yes, You require a physician’s order or referral to meet Medicare rules. Medicare Advantage plans may have additional requirements.

What if Medicare does not cover my service?
If Medicare does not cover a service, you may choose to receive it as a self-pay patient.

Can you tell me exactly what Medicare will pay?
We can explain general Medicare rules, but Medicare or your insurance plan makes the final decision on coverage and payment.

Who can I call with questions?
You may contact our office for help, or call Medicare or your insurance plan directly for detailed benefit information.