Which States Allow Medicare Excess Charges?

Most states, with the exception of those listed below, allow Medicare Part B excess charges:

• Connecticut
• Massachusetts
• Minnesota
• New York
• Ohio
• Pennsylvania
• Rhode Island
• Vermont

If you receive care out of any of the states listed above, you may incur excess charges if the provider doesn’t take the Medicare assignment amount.

Medicare Plan Quotes

Do Medigap plans cover excess charges?

Only two Medigap (Medicare Supplement) plan letters offer protection against this fee; Both Medigap Plan F and Medigap Plan G cover Medicare Part B excess charges. If you have a Medigap plan that doesn’t cover this cost, like Medigap Plan N, you’ll be responsible for paying it out-of-pocket.

How Can I Avoid Medicare Excess Charges?

If your Medigap plan doesn’t cover excess charges, you’re not necessarily out of luck. Providers are required to tell you before you receive treatment if they don’t accept the amount agreed to by Medicare. If you’re unsure what your doctor’s policy is, their office can give you that information over the phone.

How do you pay an excess charge?

You can pay the excess charge directly to your provider in whatever form of payment they accept. If the excess charge is larger than you were expecting, many providers are willing to take repayment in installments rather than all at once. You should contact your provider directly to see if this is something they’ll agree to.

Although most doctors don’t charge Medicare Part B excess charges, many people choose a Medigap plan that offers protection against them. Paying an excess charge on an occasional routine service may not amount to much, but frequent trips to the doctor’s office, outpatient surgery, or specialized care can add up quickly. And, instead of worrying about how much your treatment will cost, you can focus on finding the care that’s right for you.