Under bulk billing, who pays the out-of-pocket costs?

• A. The patient pays the full out-of-pocket amount
• B. The doctor bills Medicare directly and the patient pays no out-of-pocket costs
• C. Private insurance pays the full amount
• D. The patient pays a co-payment to the doctor

Answer: (B)

Bulk billing means the doctor accepts the Medicare rebate as payment in full for a service. The doctor bills Medicare directly, and the patient does not pay any out-of-pocket costs for that service. This is why, when a service is bulk billed, you walk in and you leave without paying a fee for that visit. Some practices offer bulk billing only for certain patients or services, or may bill differently for non-bulk-billed services, where the patient would pay the fee upfront and then claim a rebate from Medicare.