What are “excess charges” and does Plan G cover them?
Navigating the complexities of Medicare can be daunting, especially when it comes to understanding the various charges you might encounter. One term you'll often hear is "excess charges," which are additional fees that some healthcare providers may charge for Part B services. These charges come into play when you seek treatment from nonparticipating providers—those who haven't accepted Medicare Assignment. In such cases, the provider can charge up to 15% more than the Medicare-approved amount for a specific service, whether it's doctor visits, surgeries, or even emergency room visits.
This is where Medicare Plan G, a popular Medicare Supplement (Medigap) plan, offers a safety net. Plan G is an insurance coverage that complements your existing Medicare policy, filling in gaps like Part B coinsurance and the Part B deductible while providing comprehensive coverage for these Part B excess charges, ensuring you're not caught off guard by unexpected medical costs. Understanding the role of excess charges and how Medicare Plan G mitigates them can help you make informed decisions about your healthcare and insurance coverage.
How common are excess charges?
While the concept of excess charges may sound alarming, it's worth noting that they are relatively uncommon. According to statistics, only about 1% of non-pediatric physicians opt out of Medicare and can levy these additional charges. Furthermore, there are several states, including Connecticut, Massachusetts, and New York, where Part B excess charges are prohibited or limited to less than the federal limit of 15%.
If you happen to seek treatment from nonparticipating providers in other states, you could face these extra costs. These charges can apply to a range of Part B services, from doctor visits and physical therapy to surgeries and emergency room visits.
Plan G and excess charges
Medicare Plan G stands out as the most comprehensive Medicare Supplement plans, especially when it comes to dealing with excess charges. This plan not only takes care of the Part B coinsurance but also fully covers any Part B excess charges. This means that if you seek treatment from nonparticipating providers—those who haven't accepted Medicare Assignment—you won't have to worry about those additional costs.
Even when using participating providers, Plan G covers other gaps in your Medicare insurance, such as the Part B deductible, making it a well-rounded coverage plan. Whether you're scheduling doctor visits, physical therapy, surgeries, or in need of emergency room services, Plan G ensures that you're financially protected
Protect yourself from excess charges
Understanding the nuances of Medicare, particularly excess charges, is crucial for anyone looking to make informed healthcare decisions. While these additional charges are relatively rare, they can still pose a financial burden if you seek treatment from nonparticipating providers. This is where Medicare Plan G shines as a comprehensive Medicare Supplement plan. It covers the gaps in your Medicare insurance, such as Part B coinsurance and the Part B deductible, and protects you from any Part B excess charges.
Plan G is an excellent choice for comprehensive coverage and peace of mind when it comes to healthcare expenses, including Medicare excess charges and nonparticipating doctor visits, surgeries, emergency room visits, and physical therapy. Contact one of our licensed insurance agents today to learn more about Medicare Plan G or other Medicare insurance plans.
