This section provides general information only regarding Medicare, for more detailed information you may visit either Medicare web-site at www.wpsmedicare.com or www.medicare.gov or call (800) 633-4227.
Medicare has two parts:
- Part A: helps cover you while you are admitted to the hospital or skilled nursing facilities
- Part B: helps cover outpatient hospital care and doctors' services
Participating and Non-Participating Physicians
You will receive different benefits from Medicare depending on if you use a physician, supplier or pharmacy who is in net-work with Medicare or accepts assignment. If assignment is accepted the physician, supplier or pharmacy agrees to accept the Medicare-approved amount as payment. This often reduces your out-of-pocket expense since Medicare and your secondary will pay the provider direct. If you utilize a physician, supplier or pharmacy who is not in network with Medicare and does not accept assignment you may be charged a slightly higher fee (15% more than the Medicare approved amount) and may be required to pay for services and/or supplies at the time you receive them. Medicare will reimburse you its portion of the charges at a later time.
Preventive or Routine Services
Preventive services is health care to keep you healthy or prevent illness, sometimes referred to as routine care. Medicare does not cover all preventive or routine services. Please be aware that the office visit charge to perform covered preventive or routine services is not paid for by Medicare.
Visit one of the following website to learn more about your Medicare benefits:
Medicare & You (2013 version)
Discussing A Claim
If at any time you would like us to discuss a claim with Medicare you must complete an authorization form.
Authorization for Medicare
Download: (Adobe PDF)