If I Opted Out Of Medicare, Can I Choose To Opt Back In?

Before deciding to opt out of Medicare, it is important that you weigh the positives and negatives of such a move, especially if you think you might decide to opt back in again. The financial impact on your practice, and contractual obligations with hospitals and health plans might make it more trouble than it’s worth.

Opting Out Becomes A Choice

The choice to opt out of Medicare came about with the 1997 Balanced Budget Act, which, in section 4507, states that there is nothing in Medicare to prohibit a physician form entering into a “Private contract with a Medicare beneficiary” for medical service. So long as the physician doesn’t try to make a claim, or receive a payment from medicare.

Notifying Patients and Colleagues

You will have quite a few letters to send notifying patients about the change, explaining what opting out means and the options to stay or find a new physician. Also letters to colleagues that might be affected by the change, and affidavits to each carrier that has jurisdiction over claims you have filed. This affidavits need to be renewed every five years.

Loss of Income

You might also have an initial loss of income, due to having less patients. But many feel that removing constant contact with a government run system of health insurance well worth the initial inconvenience.

Opting Back In

Now, having examined the pros and cons of opting out, “Can I choose to opt back in?” For the first ninety days after opting out, you have the option of coming back, just like you had never left. Just notify the carriers to which you sent affidavits to and refund any money you made from private contracting. If you go past the ninety days, you may opt back in when it is time for your two year renewal. Simply complete a new Medicare physician enrollment form, just like you did when you where new to the program.

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