Medicare Info

Mountain Region Family Medicine, PC participates with Traditional Medicare and all Medicare Advantage Plans. There is a difference between your Traditional Medicare and a Medicare Advantage Plan. Traditional Medicare has a yearly deductible and this has to be met before Medicare will pay their 80%, leaving the patient responsible for 20% coinsurance. The deductible is applied when the patient has an office visit, x-rays, ultrasounds, MRIs and some injections also apply towards the patient’s deductible. As long as Medicare considers the lab work as medically necessary, they pay labs at 100%. There are 3 parts to Medicare: Medicare Part A, which is your hospital only; Medicare Part B, which is your medical doctors, labs, some vaccinations; Medicare Part D, which are your prescription benefits and other vaccinations. There are several Medicare Advantage Plans offered at this time and each insurance carrier has multiple plans available. Medicare Advantage Plans replace your Traditional Medicare. You never lose your Traditional Medicare, but all claims are filed through your advantage plan. The benefit in having this type of plan is that everything is handled by Medicare Advantage Plan carrier. This way you have one card to present when you go to the hospital, doctor’s office and the pharmacy. There is no deductible to meet; only copays for prescriptions, doctor’s visits and hospital. The laboratory exams are paid for at 100% as long as it is considered medically necessary. These plans follow the same Medicare guidelines. If you have any questions, please call our Patient Accounts Department at 423-230-2100 and one of our Patient Account Representatives will be glad to answer your questions or direct you to someone who can help.

 

2013 Medicare Deductibles

Part A- $1,184.00

Part B- $147.00

 

Preventative Services Mountain Region Family Medicine offers that Medicare pays at 100%

Physical Exams- once a year

Bone Density Measurement- every 2 years

Flu Vaccine- every flu season

Pneumococcal Vaccine- once a lifetime

Abdominal Aortic Aneurysm Screening- once a lifetime

Screening Pelvic Exam- every 2 years

Screening Prostate Specific Antigen Test- once a year