Just because someone googles the amount of a hip replacement or an MRI and gets an outrageous price does NOT mean that is the price they will be charged. Yes, there is a difference between the Medicare-approved amount and the amount a doctor or supplier will actually bill your insurance. A doctor or supplier can bill more than the Medicare-approved amount, but if they are a Medicare participating provider they will only be paid the Medicare approved amount. If a provider is non-Medicare participating, they may be able to charge a “limiting charge” of an additional 15%.
Your clients may be curious about how much a test or procedure will cost and if they google it they may get discouraged. Share with them that there is a specific plan type called MSA offered by Lasso Healthcare which reimburses just like Medicare. Plus, they deposit money into a special account and members can decide what health services to spend it on!
As an agent it is your responsibility to let your clients know all their options. This is a new option for 2019 that could really benefit certain clients.