Opinion
- Details
- Written by: Greg Dill
Most doctors accept Medicare as full payment for their services. But some accept it only for certain services, and others don’t accept it at all.
What does this mean for you?
If you have Original Medicare, it means you should try to use doctors, hospitals, medical equipment suppliers, and other healthcare providers that participate or “accept assignment” in Medicare. Such providers have signed agreements to take Medicare as payment in full for their services.
If your doctor or other provider accepts assignment:
Your out-of-pocket costs may be less.
– The provider agrees to charge you only the Medicare deductible and coinsurance amount, and usually waits for Medicare to pay its share before asking you to pay your share.
– The provider has to submit your claim directly to Medicare and can't charge you for submitting the claim.
– Some doctors and other providers haven't signed an agreement to accept assignment for all Medicare-covered services, but they can still choose to accept assignment for some services. – These providers are called "non-participating" providers.
If your doctor or other provider doesn't accept assignment:
– You may have to pay the entire bill at the time of service. Your provider is supposed to submit a claim to Medicare for any Medicare-covered services they provide to you.
– The provider can't charge you for submitting a claim. If they don't submit the Medicare claim once you ask them to, call 1‑800‑MEDICARE.
– In some cases, you might have to submit your own claim to Medicare using Form CMS-1490S to get paid back.
– The provider can charge you more than the Medicare-approved amount, but there's a limit. Non-participating providers are paid 95% of the Medicare-approved amount. They can only charge you up to 15% over the amount that non-participating providers are paid.
– The 15 percent limit applies only to certain Medicare-covered services and doesn't apply to some medical supplies and durable medical equipment.
Some doctors and other providers don’t want to enroll in the Medicare program at all. You can still visit these “opt out” providers, but they must enter into a private contract with you (unless you’re in need of emergency or urgently needed care).
A private contract is a written agreement between you and a doctor or other provider who has decided not to provide services to anyone through Medicare. The private contract only applies to services you get from the provider who asked you to sign it.
If you sign a private contract with an opt-out doctor or other provider, keep in mind that Medicare won't pay any amount for the services you get from that provider, even Medicare-covered services.
– You'll have to pay the full amount this provider charges you. You and your provider will set up your own payment terms through the contract.
– If you have a Medicare Supplement Insurance (Medigap) policy, it won't pay anything for the services you get. Call your insurance company before you get the service if you have questions.
– Your provider must tell you if Medicare would pay for the service if you got it from another provider who accepts Medicare.
– Your provider must tell you if he or she has been excluded from Medicare.
– You can't be asked to sign a private contract for emergency or urgent care.
– You're always free to get services not covered by Medicare if you choose to pay for them yourself.
– You don't have to sign a private contract. You can always go to another provider who participates (accepts assignment) in Medicare.
Be sure to ask your physician or other provider if they are participating, non-participating, or opt-out. You can also check by calling 1-800-MEDICARE or by using Medicare’s Physician Compare tool on www.medicare.gov .
You may want to contact your State Health Insurance Assistance Program (SHIP) to get free help before signing a private contract with any doctor or other health care provider.
Greg Dill is Medicare’s regional administrator for Arizona, California, Nevada, Hawaii and the Pacific Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).
- Details
- Written by: Pastor Chris DelCol
Jesus’ baptism was an epiphany event, a manifestation, a light and a revelation of God’s presence in this world.
In baptism, we too become God’s chosen ones. In the pouring of the water and in the saying of the words, we become God’s children. We are chosen by God. He acts, He comes to us through the water and the Word to make us His.
The baby or adult being baptized will have no active part, that is because God is the one who acts. God comes to the person and claims them for His own. God does all the action in baptism. God claims the person’s life for eternity.
A pastor stood by the grave side of a young mother with her husband and three children. The husband looked into the eyes of the pastor and demanded, "Now tell me what you really believe, Pastor, is this the end of everything, the way God meant it to be?"
The pastor said, "It’s not what I believe that matters, you have the answer in your heart. You know deep in your heart, this is not the end. You haven’t stopped loving your wife. Do you think God has? You know that life with God is eternal. God gave you that faith. All YOU have to do is believe what your heart already knows."
Yes, the claim upon us in baptism is for eternity. In our baptism, we are also anointed with the Spirit. A sign of the cross is made to seal the covenant agreement made through the water and the word.
Our sins are forgiven as it says in Titus 3:5, “He saved us not on the basis of deeds which we have done in righteousness, but according to His mercy, by the washing of regeneration and renewing by the HoIy Spirit.”
Our sins are forgiven, and at the same time, we agree to fight against sin and to confess our sins daily to God so He will drown them and raise out of the waters of our Baptism a new person.
Baptism is not a magical rite, but in baptism an agreement is made between us and God. This agreement is for a lifetime.
We ask God to cleanse us and renew us each day in the waters of our Baptism. That is not to say we need to be baptized each day, but each day we relive our baptism in that God drowns our sinful selves and raises up a new person.
So, baptism happens once, but we must live in it daily. And if we don’t keep our part of the agreement, to confess our sins, to seek God’s forgiveness, then the promise of baptism means nothing, because in our forsaken selves, we also turn away from God’s action of forgiveness.
Please join us this Sunday, Jan. 13, to hear more about Jesus’ baptism and how this sacrament is a promise of eternal life to all who believe.
Worship is at 11 a.m., followed by lunch. All are welcome so please come as you are.
Chris DelCol is pastor of First Lutheran Church in Lucerne, Calif. The church is located at 3863 Country Club Drive, telephone 707-274-5572. Email Pastor Chris at
- Details
- Written by: Pastor Chris DelCol
These men began a long trip to Israel simply because a particular star was in the sky, alerting them to the birth of the king of the Jews.
They traveled for several months perhaps even as many as two years to finally meet the Christ child in person.
I believe it is more than just a story meant to entertain us, it is meant to teach us something today, about seeking the Christ child. For God will reach to the end of the earth to call all people to worship Jesus.
Unbeknownst to many, the Wise Men from the east weren’t there in the stable. They hadn’t even left their homes yet.
But because of the lingering myths that exist about these men of gentile origin, it’s hard to find a nativity scene anywhere in the world that doesn’t have these three visitors from the East huddling by Jesus’ bedside, giving their gifts and proper worship to this One who was born King of the Jews.
As we ponder the view of the nativity scene, rather than say it is wrong, let’s instead marvel at the way in which Jesus’ birth took the whole world captive in its meaning and purpose. The people close by like the lowly shepherds and to those at the edges of the known world, the prominent and wise men.
On that first Christmas night, God announced His Son’s birth, not to top-level dignitaries or theologians, but to lowly shepherds – men who were completely undeserving of receiving such a splendid Divine revelation as this one.
The presence of the shepherds on Christmas Eve, then, is a wonderful sign of God’s grace to those who are near Him, a sign which says that it really doesn’t matter who you are, how important you are, or how respected you are in the eyes of the world.
No matter what your standing is in this world, the Good News is that God has sent His Son into the world for you and me – sent His Son to save us from His wrath and condemnation – sent His Son to take away the guilt of our sin, and to love us with an everlasting love.
In comparison, as we look at the coming of the Wise Men from the East, what we see is that the Gospel not only extends itself to those who are nearby, but also to those who are far away. We might even say that this Gospel comes especially to those who are least likely to hear and receive it.
The Wise Men, weren’t notable kings from the East who had come to visit another noble from the West, rather these men were scientists, perhaps very well off, but for all intents and purposes, pagans who’d been touched by the universal outreach of the Gospel of this King who was born beneath the Star in Bethlehem.
This is how God works His miracle of communicating the Gospel of grace in outreach to all people near and far.
Join us this Sunday to hear more about the Epiphany event where Jesus’ Divinity was made manifest to the gentile nations.
This week we have a guest speaker, Bob Hamilton, who will lead worship.
Service begins at 11 a.m. with lunch immediately following worship.
Please come as you are – all people are welcome.
Chris DelCol is pastor of First Lutheran Church in Lucerne, Calif. The church is located at 3863 Country Club Drive, telephone 707-274-5572. Email Pastor Chris at
- Details
- Written by: Evan Arnold-Gordon
New data from Principal Financial shows that more than half of the people surveyed (56%) are optimistic about the economy in next year.
“There’s no one-size-fits all magic bullet for spending versus saving. However, the more we can think about spending and saving instead of spending or saving, the better off people will be,” said Jerry Patterson, senior vice president of retirement and income solutions at Principal. “Taking a hard look at where we missed the mark and committing to making the right changes is a key step for 2019 well-being.”
Some of the top financial New Year’s resolutions in 2018 included saving more each month (46%), reducing spending each month (38%), paying off credit card debt (29%), building an emergency fund (24%), and saving more for retirement (21%) according to Principal Financial.
If you are looking to create a budget or get out of debt in the new year, BBB has tips and tools to help you get on the right track to a better financial future:
· Calculate your income. You can't properly set a financial resolution unless you know what you're working with. Calculate your monthly net income, which is after taxes, so you can set a clear budget with exactly what you are bringing home.
· Track your spending. Whether you prefer an app on your phone, computer software, or simply a notebook to jot down your expenses, keeping track is critical. It helps you see where you are actually spending your money, rather than where you think you are.
· Categorize your spending. Create categories based on necessities (housing, utilities, food, transportation) and luxuries (entertainment, dining out, travel). If you have credit card balances, student loans, car payments or other debt, make “debt reduction” one of your necessary categories. Here are some additional tips on how to pay less in some of those categories.
· Set up a budget. Once you have an idea where you are spending money, you can set up a realistic budget. There are free online tools to help you, so there is no need to spend a lot of money. Be cautious of scams, however, and never share personal identifying information (PII) unless you are sure of the site’s legitimacy.
· Pay down debt. One method is to pay off the credit account or loan with the highest interest rate first (the “ladder method”). Another is to pay off the smallest balance first so you feel a greater sense of accomplishment (the “snowball method”). Use whichever methods works best for you. The important thing is that you are doing it. Also, call your credit card company and ask if they will lower your interest rate. Some lenders will agree just to keep you from transferring your debt to another lender with better terms. If you shave even a few percentage points off of your rate, it can help you save and pay down your balances faster.
· Pay bills on time. Consider online bill-paying that eliminates writing checks, buying stamps, etc. Automatic payments can be scheduled ahead of time and can help you avoid late fees and penalties for missed payments.
· Save for the big things. Big purchases, such as vacation or holidays, can easily blow your budget. Avoid going into debt for these expenditures by saving up ahead of time and only spending what you are able to save. Many banks and credit unions offer savings clubs that might help.
· Save for emergencies. Emergencies – car or home repair, unexpected medical expenses, job loss – can blow your budget. Financial experts suggest an emergency fund of 3-6 months’ living expenses. If that is too ambitious, start smaller and build up.
· Contribute to your retirement. Make sure you are contributing enough to your 401k plan to get the full matching contribution from your employer. If you get a raise at your job, try and put that extra money aside into your retirement account. You were able to survive on that income for this long, so you won't miss that extra cash and your retirement account will greatly benefit.
· Keep track of your credit score. Credit scores are used by lenders to make decisions about whether or not to offer you credit, and what those terms (interest or down payment) will be. Your credit score is a decision-making tool that lenders use to help them anticipate how likely you are to repay your loan on time.
Additional Resources:
Make a Budget worksheet from the Federal Trade Commission
Budgeting Worksheet from Industry Canada
Evan Arnold-Gordon works for the BBB serving the San Francisco Bay Area and Northern Coastal California.
How to resolve AdBlock issue?