Medicare


Medicare

Original Medicare Plan

Reedsburg Physicians Group is a participating provider in the Medicare Part B program. This means that we accept the Medicare Part B approved amount as payment in full for services provided. Medicare typically pays 80% of the approved amount after the yearly deductible is met. The remaining 20% or co-insurance is your responsibility. If you have a Medicare supplement insurance plan or "Medigap" policy, it may cover the cost of the deductible and coinsurance amounts.

The Medicare Part B annual deductible is currently $131.00

Medicare does not cover the cost of routine physical exams or any tests or health screenings related to a routine physical. You are responsible for all amounts relating to these services.

One exception to the preventive coverage is the "Welcome to Medicare Physical Exam." As of January 1, 2005, Medicare will cover a one-time preventive physical exam, which includes specific guidelines. The exam must be completed within the first twelve months of your Medicare eligibility date in order to be covered. If you call to schedule a "Welcome to Medicare Physical Exam", you must specifically mention the exam to the scheduler so we manage the visit appropriately.

Medicare Advantage Plans

Reedsburg Physicians Group also participates in several Medicare Advantage plans such as Blue Cross/Blue Shield Smart Value and Humana Gold Choice. The coverage is similar to the original Medicare plan. However, there is a co-payment due at the time of service. Refer to your specific policy for details or contact the patient accounts department for assistance.