❋

Medicare & Medicaid

Differences in Plans

Acuity Brain Health welcomes patients with traditional Medicare, Medicaid, and Medicare Advantage plans, but payment and fees are processed differently among these plans.

We are in-network with Medicare Part B, but out-of-network with Medicare Advantage Plans and Medicaid.

Please let us know prior to scheduling if you have a Medicare vs. Medicare Advantage Plan, or Medicaid.

Traditional Medicare Part B

We are in-network with traditional Medicare Part B. You don’t have to do anything - Acuity is required to submit the charges directly to your insurance for reimbursement. You would only be responsible for the cost of any Medicare co-pays or co-insurance.

Advantage Plans & Medicaid

Acuity also serves Medicare Advantage clients with partial coverage for out-of-network benefits. You will pay Acuity and will be provided with a superbill to submit for reimbursement (out-of-network claim). Medicare Advantage plan coverage varies and will depend on your specific plan. Acuity cannot guarantee coverage of services.

Medicaid typically does not cover out-of-network services, but plan coverage varies widely. Many Medicaid plans will allow you to pay Acuity directly for your services and will provide some out-of-network reimbursement/benefits.

Other plans allow you to pay but will not allow you to submit bills for out-of-pocket reimbursement. Some Medicaid plans do not allow their patients to pay for out-of-network services, and in this case, you cannot be seen at Acuity.

You are responsible for checking with your Medicaid program regarding your plan benefits, prior to calling Acuity to schedule.