• Skip to primary navigation
  • Skip to content
  • Skip to primary sidebar
  • Skip to footer
515-218-8022
  • Facebook
  • Twitter
  • LinkedIn
Senior Savings Services

Senior Savings Services

Your Medicare Options Simplified.

  • About
    • Testimonials
  • Medicare Options
  • Articles
  • Helpful Links

Get a Quote

What are Medicare Part B Excess Charges?

July 24, 2018 by John Bush

Medicare Part B Excess charges are related to doctors and other outpatient healthcare providers, including medical supplies. This is not charged by all providers, however, in most states, providers have the option to charge “excess”.

Participating Providers are ones that have signed an agreement to charge you a Medicare approved amount for their services, which is also known as “accepting Medicare Assignment”.  Most doctors, providers, and suppliers do accept assignment.

Non-Participating Providers are those that have not signed an agreement to accept Medicare Assignment. Due to this, they can charge excess charges. These excess charges can be up to 15% above the Medicare approved amount.

To illustrate, for example, say a procedure has a Medicare approved amount of $1,000. The most the provider could charge you, in this case, is $1,150. If you carried Medicare Supplement Plan that didn’t cover excess charges, you would pay the additional $150 “excess charge” ($1,000 x 15% = $150 excess charge).

 

What are the odds you’ll be charged excess charges? And How can you avoid them?

Statistics have shown that 96% of providers do accept Medicare Assignment. Thus, excess charges are fairly uncommon. What can you do to protect yourself from excess charges? Ask the doctor you are about to see if they accept Medicare assignment before you make an appointment. Then you will know you won’t be charged excess charges. Further, I would also advise asking this same question of other providers such as rehabilitation services, lab facilities, medical supplies, etc.

Currently, both Medicare Supplement Plan F and Plan G cover excess charges, so you could avoid paying having to pay anything out of your own pocket, should they be charged.

Some states do prohibit excess charges. Those states are: Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont. If you reside in or receive services in these states, you cannot be charged excess charges.

 

About the Author

John Bush has been an independent insurance broker helping those on Medicare learn of their rights and options since 2010. He has helped many people find the right plan that is best for them. John is passionate about helping people in a manner that is easy to understand, resourceful, and non-pushy. John helps people get the best coverage for their premium dollar without sacrificing customer service.

Category iconMedicare Tag iconMedicare Excess Charges

Reader Interactions

Primary Sidebar

Related Articles

  • Medicare Medical Savings Account (MSA)

  • Medicare Supplement Options if Under Age 65 and on Medicare

  • How Does Medicare Compare to My Employer Health Plan?

  • Cancer Costs

  • 2019 Medicare Numbers

Products

  • Medicare Planning
  • Dental, Vision, & Hearing
  • Nursing Home Care / Home Health Care
  • Life Insurance

Proudly based in Des Moines, IA

Services provided all over the United States

Footer

Connect with Senior Savings Services

  • Facebook
  • Twitter
  • LinkedIn
515-218-8022
info@srsavings.com

Not connected with or endorsed by the United States Government or the federal Medicare program. Medicare has neither reviewed nor endorsed this information.

I do not offer every plan available in your area. Any information I provide is limited to those plans I do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.

© 2022 Senior Savings Services.