Your Health

Understanding Medicare Reimbursement and Claims

Medicare Part C

Medicare part C, also known as Medicare Advantage, is private insurance. It covers all services in both part A and part B, along with prescription medications, vision, dental, and other services. Most provider will file claims. You will never need to file for reimbursement for an outstanding amount from Medicare. If you are billed directly for these covered costs, you may have to file a claim with a private firm for reimbursements. Medicare part C includes many options, including PPO and HMO. Each of them has out-of-network and in-network providers. In some cases, you would need to file a reimbursement claim when visiting an out-of-network provider. Keep in mind to be informed about coverage rules upon registration. If they charge you a covered service, ask the insurance firm to know how to file a claim. [4]