I am a Medicare beneficiary. What does this mean for coverage and why do I have to sign the Medicare Agreement?
Parsley Health clinicians are opted out of Medicare. The Medicare Agreement is required by all of our members and acknowledges that you agree not to submit a claim, or to ask the clinician to submit a claim, to Medicare.
Though our providers have opted out, they do have order and refer privileges, which means they are still able to place lab orders and recommend referrals using your insurance plan.
Please know that once you’re connected with a clinician, you will have a dedicated Care Manager to support you in navigating testing and cost.
- Membership Reimbursement: Because Parsley Health clinicians are opted out of Medicare, we are unable to support claims or reimbursement for visits. Your membership fee is an out-of-pocket expense that can't be submitted to insurance for reimbursement.
- Testing: Even though our providers have opted out of Medicare, they are able to order and refer testing for Medicare members. This means we can still place lab orders, and you should be able to receive partial insurance coverage.
- Additional Testing Alternatives: If you'd like to complete testing through your PCP, we'd be happy to facilitate that with your PCP’s support. Your provider may request a few "non-routine" markers that your PCP may not be comfortable ordering for you, but we can always adjust the order to something your provider is comfortable with and order the remaining tests through another lab. If you are looking for a more upfront testing estimate, we also can work with an out-of-network lab called Vibrant America to coordinate your testing. This lab does not accept insurance and can run the majority of the testing our clinicians recommend. Once we have your clinician’s testing recommendations, your Care Manager can support you with understanding the cost, which typically runs for $200-$300 through Vibrant.
Please note that if you don’t sign our Medicare Agreement, Parsley Health is unable to provide you with services.