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The $74,973 Question: Are Medicare Beneficiaries Informed Users of Private Medical Care Contracts?

Research output: Contribution to journalArticlepeer-review

Abstract

Health-care providers are allowed to opt-out of Medicare, privately contract with beneficiaries, and require that beneficiaries pay the full cost of services. Responses from a nationally representative sample of Medicare beneficiaries reveal that they lack the knowledge necessary to make informed decisions regarding such contracts. For example, only 4.6% of participants knew the correct answer to a real-life $74,973 question, leaving a full 95.4% vulnerable to paying a large bill, even a $74,973 bill, they should not pay. In addition to advocating that Medicare effectively monitor private medical care contracts, social workers should educate beneficiaries and/or their caregivers on the implications of entering into such contracts or refer them to their State Health Insurance Assistance Program or Senior Medicare Patrol program for expert guidance.

Original languageEnglish
Pages (from-to)4-15
Number of pages12
JournalJournal of Gerontological Social Work
Volume62
Issue number1
DOIs
StatePublished - Jan 2 2019

ASJC Scopus Subject Areas

  • Social Sciences (miscellaneous)
  • Nursing (miscellaneous)

Keywords

  • Medicare
  • balance billing
  • beneficiary knowledge
  • opt-out

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