Medicare reimbursement/refunds

So, apparently, if you can't get an appointment at the hospital within a 30-day window, you have the option to see a private specialist and then file a claim with Medicare to get reimbursed...

Has anyone actually gone through this process before? Medicare tends to be a bit tight-lipped when it comes to providing clear information on these kinds of things...

Good luck getting that refund.
I guess it’s just another case of people being led to believe they can somehow claim these massive, totally unrealistic benefits from Medicare 🙄

Reimbursement applies specifically to specialist visits (like an endocrinologist), but only if it’s your very first appointment. Your primary doctor is required to check the correct box on the referral—either FIRST VISIT or FOLLOW-UP—and they usually ask you which one it is when you're booking. If that specialist then refers you for further diagnostic testing (say, an MRI where the waitlist is six months long), this law won't help you. It doesn't cover diagnostics.
If a specialist can't see you for that initial visit within 30 days, they are legally obligated to provide you with documentation stating both the date you requested the appointment and their earliest available opening. This proves they missed the 30-day window. You take that paperwork, along with the receipt from a private clinic if you decide you can't wait, and submit it to Medicare. They handle the reimbursement process—which, if I understand correctly, means the facility that couldn't see you in time is the one footing the bill.
At least, that's what I was told.😉