Excess Charges explained
Over the years, both training insurance agents and helping Medicare beneficiaries, Excess charges come up and seem to be a confusing topic and one that is easy to be afraid of, after all, we are all a little afraid of what we don't understand.
An excess charge is an amount that the doctor can charge above the amount Medicare approves, up to 15% over in most states.
For example, let's say you go to the doctor. Let's assume that Medicare says the approved amount for that particular appointment is $100. The Doctor can charge a 15% balance bill for the visit, which would be an additional $15.
Now keep in mind this only applies to Orignal Medicare, and not the Medicare Advantage plans.
These excess charges are easy to avoid, you can simply ask the doctor if they accept Medicare assignment, If they do, they will not charge the excess charge.
Round numbers were used for explanation purposes; We're not stating that a doctor visit has a Medicare-approved amount of $100.