Maryland Life and Health Insurance License Practice Exam

What is a requirement for medical providers who accept Medicare Assignment?

1. To charge additional fees to patients

2. To balance bill patients for unmet costs

3. To accept payment based on a defined Medicare schedule

4. To only treat Medicare beneficiaries

The correct answer is: To accept payment based on a defined Medicare schedule

Accepting Medicare Assignment means that medical providers agree to accept the approved amount set by Medicare for services rendered, rather than charging patients additional fees beyond this amount. This is essential for maintaining compliance with Medicare program guidelines. Providers who accept this assignment cannot bill patients for the difference between their standard charges and the Medicare approved amount, thus ensuring that patients are only responsible for any applicable deductible or coinsurance as per Medicare's rules. This agreement benefits patients by protecting them from unexpected high bills, as the provider cannot charge more than the amount Medicare decides is reasonable. This ensures a level of transparency and predictability in healthcare costs for Medicare beneficiaries, who are often on fixed incomes. Accepting payment based on a defined Medicare schedule is thus a fundamental aspect of the Medicare assignment structure, serving both the provider’s financial operations and the patient's financial planning.