Of primary importance to psychiatrists is the coverage for Medicare Part B coinsurance, which is included in all of the Medigap plans. Some psychiatrists have reported problems with obtaining the correct reimbursement from Medigap. Every Medigap policy covers the entire Part B coinsurance amount for outpatient mental health treatment. If you continue to have problems, contact the APA's Office of Economic Affairs and Practice Management for assistance in resolving the problem. Not All Plans Are Medigap Be aware that not all Medicare supplement plans are Medigap.
Many employers provide health benefits to retired employees.
Once a beneficiary reaches the age of 65, these benefit plans become secondary to Medicare. While these plans may supplement the beneficiary's Medicare coverage, they are not Medigap plans and are not required to meet Medigap plan requirements. In addition, many federal requirements do not apply to Medigap policies that were sold before 1992, when Medigap was standardized. For these older policies it is important to verify benefits with either your patient, their Medigap plan, or both. If you are a participating provider with Medicare, your local Medicare carrier is required by law to forward your claim to the patient's Medigap insurer for processing.