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BenefitsLink > Q&A Columns >

Stop, Look & Listen: Railroad Retirement Benefits Q&A

Answers are provided by Robert S. Kaufman

Problem with Doctors Not Billing Medicare

(Posted June 28, 2015)

Question 1234: I am a retiree receiving Medicare through the Railroad Retirement Board. In the past, I have attempted to make appointments with physicians who accept Medicare. However, I have been turned away because they say they only accept "traditional Medicare" (Medicare administered through the Social Security Administration). When I explained that it's the same federal insurance program, only administered by a different federal agency (RRB), I am still turned away. Are physicians who accept Medicare administered by the Social Security Administration obligated to accept Medicare administered by the RRB? If so, is there a document I can provide to them indicating their obligation to do so? This is a very serious issue because my secondary medical insurance company will not cover anything that is not initially submitted to Medicare.

Answer:

There is no difference between Medicare coverage and benefits for people enrolled by SSA or the Railroad Retirement Board. But there is a difference if you have regular Medicare or you have chosen to join Medicare Advantage. If you have Medicare Advantage, you usually have to use only doctors who are in the Medicare Advantage plan you've selected.

If you still have questions about doctors who won't bill Medicare for their services, you should contact the Centers for Medicare & Medicaid Services, which is the federal agency responsible for Medicare. Their toll-free number is: (800) MEDICARE.


Important notice:

Answers are provided as general guidance on the subjects covered in the question and are not provided as legal advice to the questioner or to readers. Any legal issues should be reviewed by your legal counsel to apply the law to the particular facts of this and similar situations.

The law in this area changes frequently. Answers are believed to be correct as of the posting dates shown. The completeness or accuracy of a particular answer may be affected by changes in the law (statutes, regulations, rulings, court decisions, etc.) that occur after the date on which a particular Q&A is posted.


Copyright 1997-2017 Robert S. Kaufman
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