Medicare does not require prepayment

Medicare does not require people to pay in advance for their care.

Doctors who accept assignment from Medicare should not be billing patients in advance for the entire sequence of their services. Assignment means the health care provider agrees to accept Medicare-approved charges as payment in full for their services.

Most doctors who accept Medicare also accept assignment, but it’s possible for a doctor to accept Medicare patients without agreeing to assignment. Such “non-participating” doctors can bill you more than the Medicare-approved amount for their services, although Medicare rules do limit such overcharges. These doctors also can bill you the entire charge for their service.

Medicare rules permit doctors  up to a  year to file your Medicare claims; most do so sooner. If your claim has not been processed by Medicare, you can either ask your doctor to file it again, or if the year deadline is approaching, you can file the claim yourself using Form CMS-1490S.

These claim rules apply to Original Medicare. Private Medicare Advantage plans usually restrict coverage to care providers in their provider network, who provide services at costs approved by the plan.