Certified Financial Consultant (CFC) Practice Exam

What is a potential downside for individuals using non-participating Medicare providers?

1. Higher overall costs

2. Guaranteed cost coverage

3. Immediate service access

4. Unlimited provider options

The correct answer is: Higher overall costs

Choosing non-participating Medicare providers can lead to higher overall costs for individuals. These providers do not accept the Medicare-approved amount as full payment for their services and can charge up to 15% more than that amount, known as excess charges. This means that patients might have to pay a larger portion of their bills out-of-pocket, especially if they receive services that exceed the Medicare limits. The other options do not accurately represent potential downsides associated with non-participating Medicare providers. Guaranteed cost coverage is typically associated with participating providers who agree to accept the Medicare-approved payment as full payment, which helps control costs for patients. Immediate service access is not inherently linked to non-participating providers, as access can vary based on numerous factors, including the provider's own policies and patient loads. While non-participating providers may offer a range of services, the choice is often limited due to the higher costs involved, which can deter patients from seeking care from these providers.