Medicare

Brumm Eye Laser Center physicians participate with Medicare. This means that the patient is charged the amount that Medicare allows. This does not mean that Medicare patients will never have to pay for services. It is likely that patients will have a balance after the Medicare payment.

DEDUCTIBLES & CO-PAYMENTS

The deductible is the amount a person must pay toward medical bills in a calendar year before Medicare benefits are provided. The deductible for physician services is $100. After the deductible is met, Medicare pays 80% of the allowed fee for all covered medical expenses incurred during the year. The remaining 20% is the co-insurance; this is the amount billed to the patient or the patient’s secondary or supplemental insurance.

FILING PROCEDURES

Brumm Eye Laser Center will electronically file claims for covered office services. Once we have received the explanation of benefits (EOB) from Medicare with either their 80% payment or their denial of benefits, we will then forward the remaining 20% to the secondary or supplemental insurance company.

SERVICES NOT COVERED

Medicare does not cover all services such as routine examinations where no medical diagnosis in involved. It also does not cover the cost of a refraction (that part of the eye exam that determines the power of a patient's prescription for eyeglasses). The patient will be expected to pay for these charges at the time of service. Brumm Eye Laser Center will bill Medicare for covered surgical services. After Medicare has responded, a claim will be forwarded to the secondary or supplemental insurance company.