Medicare excess charges are an amount up to 15% above and byond the Medicare approved amount for a given service by a physician.

If a doctor who takes Medicare also accepts assignment, they are accepting the Medicare approved amount as payment in full, meaning you do not have to worry about receiving bills for excess charges.  When a doctor does not accept assignment, they reserve the right to charge an amount above and beyond the Medicare approved amount, up to 15%.  For example, if you have a service completed that Medicare says costs $1,000 and the doctor accepts Medicare, but not assignment, he/she can charge the insured up to an additional $150 for the service. ($1,000 x 15% excess charge maximum = $150).

A Medicare supplement plan is a great way to protect yourself against receiving excess charges. If your primary care physician accepts Medicare, but does not accept assignment, you may want to secure a Medigap plan F or plan G.  If your doctor does accept assignment, a plan N may be more suitable to your needs.  Plans F & G will cover excess charges – the other Medicare supplement plans will not.

There are a number of states that do not allow physicians to bill excess charges to patients (due to the Medicare Overcharge Measure Law) – these states include Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island and Vermont. In these states, a plan N is a great option to consider as it can save you a lot of money in premiums.

To learn more about how Medicare excess charges work and to compare Medicare Supplement plans in your area, give us a call at 1-888-972-0024 to speak with our Medicare Supplement agents who can answer all of your questions.  You can also CLICK HERE to e-mail us 24/7.



Medicare Supplement Plans, you can compare plans on our website, or call us today and talk to one of our expert Medicare Advisors who are standing by ready to answer all your questions.