How to avoid Medicare Excess Charges

Learn which Medigap plans cover excess charges and where they are not allowed

Katie Banks

Sep 10, 2019

Last Updated: Nov 18, 2020 2:25 pm

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%.

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
Massachusetts
Minnesota
New York
Ohio
Pennsylvania
Rhode Island
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?

Enrolling in Medigap with Senior65.com

We at Senior65.com can help you enroll in Medigap at the lowest price allowed by law. That’s right, we charge you absolutely nothing for our services. Give us a call when you are ready to enroll.

New to Medicare: Everything you need to know. Medicare is the United States federal health insurance program for Americans 65 and older, as well as people with certain disabilities or End Stage Renal Disease (ESRD).
Medigap Overview You may already know that Medicare covers you up to 80%. A Medigap plan will take care of the remaining 20%. This means that whatever Medicare covers, Medigap will cover too.
Medigap FAQ Medicare is a good start but has gaps in its coverage. These gaps could cost a lot of money should you have certain medical needs or conditions. Additionally, Medicare requires that you first pay deductibles before benefits begin. That is where Medicare Supplemental Insurance (Medigap) comes into plan.