Every day in America, a grandfather walks into the dermatologist’s office, the doctor examines a concerning mole, then removes it during the same visit. Medicare may pay for the office visit and the procedure separately, at close to full price. That’s one visit but two charges, and grandpa owes coinsurance on both. This could be the eye doctor or another specialty, also, but the double billing for both an evaluation and a procedure is quite common.

And it’s a problem. The evaluation and management fees can total hundreds of dollars. With Medicare Part B coinsurance at 20%, a senior may owe nearly $50 for the visit, then face another cost for the same-day procedure. For someone living on a fixed income, that money might have been needed for groceries, utilities, or a prescription.