How do Medicare and Medigap pay medical bills?

Medicare and Medicare supplement plans go hand in hand. If a person has just Medicare policy that only a part of the bills will be paid and will leave a huge chunk of bills including deductibles and copayments to be paid by the person. This might seem to be a small amount but actually accumulates to be a heavy amount. Medigap policies cover these extra costs and prove to be a smart move as all the medical expenses are covered. The best part is that the payment of medical bills is done automatically thus making it extremely easy to use.


Approval and billing:

In certain cases, the tests and scans might need prior approval from the Medicare that it will cover the bill. So before any tests like MRI or CAT scan or any other expensive test is scheduled, the hospital first gets a confirmation from Medicare. The communication is swift and easy and done electronically. After the tests or procedures are done, the bill is sent to Medicare electronically and it pays for the amount responsible directly to the hospitals.

Gaps filled by Medicare supplement plans:  Get enrolled at

Now Medicare pays only for the portion that Medicare policies cover. The rest of the bill is then paid by Medigap if the person has one. Medicare uses a system called “crossover” under which the Medigap Insurance Company gets electronically notified. The only thing a person needs to do is show the Medicare supplement plan identification card along with the Medicare card to the present medical providers and the rest is taken care of.

It might happen that insurance companies do not approve the medical treatments because the only job for insurance companies is to pay the bills for bills that have been approved by Medicare. SO it is important to check whether the services and treatments needed are covered by Medicare or Medigap supplement plans.

Billing issues:

There are hardly any billing issues but if in certain cases if the bill is not paid as a  result of a bill getting lost in the system, it is an easy process to file it with Medicare. To make sure that all the bills are paid, a cross-check can be done with the Explanation of benefits mailed by Medicare that contains a summary of the approved and paid bills. An account can also be created on an online Medicare website where the bills can be viewed as per needs.