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 language | English |
|---|---|
| Pages (from-to) | 4-15 |
| Number of pages | 12 |
| Journal | Journal of Gerontological Social Work |
| Volume | 62 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2 2019 |
ASJC Scopus Subject Areas
- Social Sciences (miscellaneous)
- Nursing (miscellaneous)
Keywords
- Medicare
- balance billing
- beneficiary knowledge
- opt-out
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