This Podcast Is About Medicare Part B Excess Charges
In Episode 13 of the Medicare Podcast by Medigap Seminars, Matthew Claassen explains Medicare Part B excess charges—what they are, when they can happen, and how to avoid them with one simple habit. Most people never learn about excess charges until a surprise bill arrives. This episode is designed to prevent that.
For more Medicare education, visit:
https://medigapseminars.org/medicare-basics/
What Are Medicare Part B Excess Charges?
A Part B excess charge is an additional amount a doctor may bill above the Medicare-approved amount for certain outpatient services. Excess charges only happen under specific conditions: the service must be under Part B, the provider must be non-participating, and the provider must not accept Medicare assignment.
Most doctors do accept assignment, which is why many beneficiaries never encounter this issue.
Learn more about Medicare Part B basics here:
https://medigapseminars.org/medicare-part-b
What Excess Charges Are Not
Excess charges do not apply to Medicare Part A. Hospitals cannot bill Part A excess charges. Emergency and urgent care are not subject to excess charges, and Medicare Advantage plans do not allow them. Providers who accept Medicare assignment cannot bill excess charges.
Participating vs Non-Participating Providers
Participating providers accept Medicare assignment, meaning Medicare sets the price and the provider agrees not to charge more. Non-participating providers may accept Medicare patients but can choose not to accept assignment on certain services, which is where excess charges and upfront payment requests often appear.
A deeper look at provider billing and Medicare costs:
https://medigapseminars.org/medicare-costs
How to Avoid Excess Charges
The easiest solution is to check the provider before you go. Use Medicare.gov’s Care Compare (Physician Finder) tool to confirm the doctor accepts assignment. If they do, excess charges cannot occur.
Do Medigap Plans Cover Excess Charges?
Some Medicare Supplement plans cover excess charges (Plan G does; Plan N does not). If you want help choosing the right coverage strategy, visit:
https://medigapseminars.org/medigap-plans
Or request a free review at:
https://medigapseminars.org
