Part B Excess charges occur when a doctor charges more than the Medicare-approved amount. This happens when the healthcare provider does not accept Medicare assignment and decides to charge you extra. They are legally allowed to do this up to a maximum of 15%. Excess charges are very rare but this article give you some ways to ensure you never pay them. (source)
How to avoid Medicare Excess Charges
Enroll in Medigap Plan G or Plan F
Medigap plan F and plan G both cover 100% excess charges so your insurance company will pay those extra fees, not you.
Seniors who turn 65 before 2020 can still enroll and keep their Plan F as you can read in our article about all the Plan F changes in 2020. Medigap Plan G not only covers 100% of your excess charges but because it has a lower premium it is usually a better deal than Plan F, so if you were planning on getting the latter make sure to check the price of Plan G first.
Needless to say, every variant of Plan G and Plan F like Innovative F or G Extra also covers excess charges.
Some states do not allow excess charges
That means that if you live in one of these states, you will not have to pay these charges. Here is a list:
- Connecticut (Only those who are in the “Qualified Medicare Beneficiary” level of the Medicare Saving program do not pay Part B Excess Charges. Read all about Medigap Plans in Connecticut here)
- Massachusetts (Find comprehensive information on Medigap Plans in Massachusetts right here)
- Minnesota (Discover all you need to know about Medigap Plans in Minnesota by reading this)
- New York (In NY Excess Charges are mostly limited to 5% above the Medicare-approved rate.
Get the full scoop on Medigap Plans in Connecticut by checking out this article) - Ohio (Explore the details of Medigap Plans available in Ohio through this comprehensive guide)
- Pennsylvania (Dive into the specifics of Medigap Plans available in Pennsylvania here)
- Rhode Island (Click through to learn the ins and outs of Rhode Island Medigap rules.)
- Vermont (Find out more information regarding Medigap Plans available in Vermont)
If you reside in one of these states, you may want to consider a Medigap Plan N. Medigap N is less expensive than Plan G but doesn’t cover excess charges. If you live in a state that doesn’t allow excess charges, why pay for a benefit that you will most likely not use?
Excess charges are Rare
98% of non pediatricians doctors accept the Medicare assignment which means they will not charge you excess charges. So take these tips with a grain of salt. Very few doctors charge excess charges but nobody likes surprise bills so we put togher the tips above (source).
Enrolling in Medigap with Senior65.com
There is never a charge or hidden fee to work with Senior65.com. Since Medicare Insurance prices are regulated, no one can sell you the same plan for less than we can. Give us a call when you are ready to enroll.