I am a Medicare provider. If you have Medicare Part B, I can work with you. If you have a Medicare supplement plan or a secondary plan from a retirement fund or previous employer, that should be OK too. Usually, Medicare sends the claim on to the secondary insurer. If not, I will need to submit a secondary claim. Without Medicare supplemental coverage, you will need to pay the coinsurance amount of 20%.

Some Medicare supplement plans “carve out” the supplemental coverage. One example is State of Illinois plans with Aetna supplemental coverage, which is carved out to Magellan Health. This makes the process more complex, but I have successfully worked with that.

Regarding Medicare Advantage all-in-one plans, check your provider list and benefit book. If it’s a PPO and I’m on the network, I should be OK. If it’s a Medicare Advantage HMO, I may or may not be covered, since you may need a referral from your primary physician and need to stay within their group. Humana Medicare Advantage is an example of that. Even though I am a Humana provider, you may need pre-authorization from your physician. Check with the PCP’s office or Humana.

Medicare Coverage by Fitzgerald Counseling is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.