Medicare Glossary

Assignment

An agreement by a doctor, supplier, or provider to accept the Medicare-approved amount as full payment for a covered service. Providers who accept assignment cannot bill you for more than that amount, aside from normal deductibles and coinsurance.

Non-participating Provider

A doctor or supplier who does not accept Medicare assignment but is still enrolled in Medicare. They may charge up to 15% more than the Medicare-approved amount (the limiting charge). Medicare will still pay its share, but you may pay more.

Also known as: Non-par provider

Out-of-Network

Providers, facilities, or suppliers that do not have a contract with your health plan. Using out-of-network providers often costs more. Some Medicare Advantage plans (like PPOs) allow out-of-network use at higher cost; others (like HMOs) generally do not.