Medicare Benefits Coverage

Dr. Firestein is a participating provider for Medicare and accepts original Medicare coverage.

sample medicare

She is able to bill Medicare for you.  They usually cover approximately ½ of the charges for therapy sessions.  If you also have a Medicare Supplement, in most cases Medicare will automatically bill your secondary insurance and you will not have to do so. In this case, the primary (Medicare) plus your supplement will usually cover the majority (and sometimes 100%) of your charges for psychotherapy. Please keep in mind, however, that there may be a deductible or co-pay for the services provided.  If so, those amounts are due at the times services are delivered.

Dr. Firestein regrets that she is unable to accept or bill for clients with “Medicare Advantage” plans, such as those affiliated with Humana, United Health Care, or other third party insurance administrators because she is not a preferred provider for these Medicare plans.  This is an example of one type of Medicare Advantage card from Blue Cross Blue Shield:

Sample UAW Trust Medicare Plus Blue Group PPO ID Card

sample uaw

If you have a Medicare Advantage Plan and you wish to see Dr. Firestein, she will charge you the Medicare allowable rates (see above).

The Medicare approved rate for an initial session is the same as her regular initial session rates. Subsequent sessions are in accordance with Medicare allowable rates for participating providers, which are substantially less than Dr. Firestein’s usual rates for therapy.

Therapy sessions for Medicare patients normally run 55 minutes.  Shorter sessions (e.g. 45 minutes) may also be utilized.  The length of the session is dependent upon the client’s needs.

TRIWEST AND TRICARE

Dr. Firestein also works with TriWest and TriCare Health Plans for active and retired military and some federal government employees.  Ask for further details.

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