If you’ve been researching Medigap coverage, you may have seen that F and G are the two plans that cover excess charges. It’s unlikely that you’ll be billed for excess charges, but it’s important to know what they are and how they may affect your out-of-pocket expenses. The Fussell Group can help you understand Part B excess charges.
What Are Excess Charges?
Doctors and other providers may decide to participate with Medicare. Those who do agree to charge the amount approved by Medicare for their services. When they agree to accept the Medicare-approved amount — as full payment for covered services — they’re accepting Medicare assignment.
Medicare assignment is another term that you should know.
Note: You shouldn’t be worried about excess charges. The average amount is usually about $20 or less.
How to Avoid Excess Charges
The easiest way to avoid these charges (if you live in a state that allows them) is to always visit a doctor that accepts Medicare assignment.
If the provider doesn’t participate in Medicare, they might bill you up to 15% more than the allowed rate. That’s why it’s called an excess, or “extra” charge. You’ll need to pay this amount out-of-pocket, but again, it won’t be much.
The other way to avoid excess charges is to buy a Medicare Supplement Plan F or G that covers them.
Some States Don’t Allow Excess Charges
Some states protect seniors from excess charges. To make this happen, they passed laws that keep providers from charging people above the rate that Medicare accepts. They are:
- Connecticut
- Massachusetts
- Minnesota
- New York
- Ohio
- Pennsylvania
- Rhode Island
- Vermont
If you have Medicare and you live in one of these states, you may consider Medigap Plan N. It has similar coverage to G but comes with lower premiums because it does not cover excess charges.
Related Post: Which Medicare Supplements Offer the Most Coverage?
What Else You Should Know
Most physicians have agreed to participate with Medicare — meaning they’re Medicare-approved. If a doctor opts out of Medicare, they must let their patients know.
Also, excess charges don’t count toward your Part B deductible ($203 in 2021). If you often see a doctor who doesn’t accept Medicare assignment, the excess charges could add up by the end of the calendar year.
Related Post: Key Medicare Terms A-Z
Choose The Fussell Group Insurance Advisors
When you need help with your Medicare options, contact The Fussell Group. Our advisors have over a decade of experience in Medicare, and a combined fifty years in the insurance industry! Whether it’s an Advantage plan or a supplement policy, we’ll help you find the right coverage for your situation.