Insurances & Medicare

 

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At Summit Medical Group Oregon, we know you have many choices when it comes to Medicare coverage. From original Medicare, with or without a supplement program, to various Medicare Advantage plans offering extra supplemental programs.

We believe that the best way for you to enjoy life is to stay healthy and we encourage you to look at a Medicare Advantage plans for this reason. Medicare Advantage plans offer high quality value-based plans, often with added benefits to focus on your overall health. Here at Summit Medical Group Oregon we refer to this focus as TotalCare©.

Medicare Advantage plans (Medicare Part C) provide your Original Medicare (Part A and Part B) benefits through a private insurance company that contracts with Medicare. Medicare Advantage plans provide the same coverage as Medicare Part A and Part B (except hospice care, which remains covered under Medicare). But you often get more benefits with a Medicare Advantage plan — like routine vision, dental, and hearing services.

Summit Medical Group Oregon strives to participate in all options so we are ready to serve you no matter what your final decision on coverage is. Summit Medical Group Oregon also partners with a few local Medicare agency-approved organizations to assist you in selecting the plan that best fits your needs. Medicare Help and Medicare Wire are two we suggest you reach out to for help.

The list below represents those insurance carriers we most commonly bill on behalf of our patients. This list is subject to change and may not include all insurance or networks we bill. Contracting with an insurance company does not guarantee coverage or payment. Patient deductibles, co-insurance, co-pays, and non-covered services are the responsibility of the patient and are due at time of service.

Our billing team is available by phone at 541-317-4200 to assist when needed.

Insurance and Networks Accepted Include:

We also participate with TriCare and TriWest as a referral source for our local agencies.

 

Summit Medical Group Oregon accepts Medicare, Medicare Advantage and all supplemental Medicare plans. Because Medicare changes frequently, it’s helpful to visit the Medicare website for the most up-to-date information.

Summit Medical Group Oregon is a participating provider with Medicare. We have a contract with Medicare to provide services to entitled beneficiaries. Medicare patients will be billed only for deductibles, co-pays and non-covered charges.

As a participating Medicare provider, we are required to screen Medicare patients according to the Medicare Secondary Payor (MSP) rules. At each visit, Summit Medical Group Oregon representatives will ask you the MSP questions. These questions will help to confirm if Medicare or another payer should process the claim as the primary insurance.

This may add some time to the check-in process; we apologize for any inconvenience and appreciate your understanding.

Medicare supplemental insurance

If you have additional insurance coverage in addition to Medicare, Summit Medical Group Oregon will bill your supplemental insurance company for any amounts Medicare does not pay. Medicare supplemental and retirement plans may not cover the entire balances after Medicare. Amounts not paid by Medicare or other insurance will be your responsibility.

Medicare as a secondary insurance

Medicare will not cover you for your primary insurance if:

  • You or your spouse are still working and is covered by an employee group health plan
  • Your were involved in an automobile accident
  • You were injured and some other party may be liable for the injury. This includes Workers’ Compensation claims for Medicare insured persons who are still working

In these cases, please provide information regarding the employer group insurance, automobile coverage, or the Workers’ Compensation claim. A Medicare claim will be submitted for any balance the primary insurance does not pay.

We know billing can be confusing and we want to help make it clear for you. We would be happy to answer any additional questions. Please call the Billing Customer Service Department at (541) 317-4200 between the hours of 8a.m. and 5p.m. The Customer Service or Member Service Department from your insurance may also be able to answer specific questions for you. Often their phone number is printed on the identification card provided to you.