Most people feel relieved once their Medicare coverage starts — but there are still some small details that can sneak up on you. One of those is called a Part B excess charge. Below, this Supplemental Medicare agency in Northwest Indiana is going to explain what these charges are, how they can affect you, and how Medigap Plan G or Plan F can protect you from them.

What are Part B excess charges?

With Original Medicare, you have Part A, which covers hospital care, and Part B, which covers doctor visits and other medical services. Medicare sets a price for what they will pay for those services.

If your doctor accepts a Medicare assignment, they basically agree to take the Medicare-approved amount as full payment.

But not every doctor agrees to those terms. Some are non-participating providers. That does not mean that they will not see Medicare patients. It just means that they can charge up to 15% more than what Medicare pays. That extra amount is called a Part B excess charge.

Let’s say you see a non-participating doctor for a procedure. Medicare pays its share, but the doctor adds up to 15% more to the bill. You are responsible for that extra part. For small things, it might not seem like much. However, with specialist visits, tests, or more extensive procedures, those extra costs can add up quickly.

Thankfully, most doctors who see Medicare patients do accept assignments. You might not run into excess charges very often. But it can still happen, especially if you travel or see specialists outside your usual area.

How does Medigap Plan G or Plan F protect you?

Medicare Supplement (Medigap) plans cover the costs Original Medicare does not. That includes things like deductibles, copays, and, yes, excess charges.

However, not every Medigap plan covers excess charges. Only Plan G and Plan F do.

If you have Plan G or Plan F, you don’t have to worry about whether your doctor accepts Medicare’s price limits. You are covered for those extra charges.

Plan G vs Plan F—what’s the difference?

Both Plan G and Plan F offer strong coverage, but there are a few differences to know.

Plan G covers almost all your out-of-pocket costs under Original Medicare. That includes copays, coinsurance, and excess charges. The only thing it does not cover is the Part B deductible, which is a small yearly amount you pay before Medicare starts paying. Even with that, Plan G is one of the most popular choices for broad, reliable coverage.

Plan F covers everything Plan G does, plus the Part B deductible. The catch is that Plan F is only available to people who became eligible for Medicare before January 1, 2020. If you are new to Medicare, Plan G will likely be your best choice for comprehensive coverage.

Even if you qualify for Plan F, it’s best to sit down with a Supplemental Medicare agency in Northwest Indiana to compare costs. Plan F usually has higher monthly premiums. Depending on your health needs and budget, Plan G could give you much better value.

Don’t overlook excess charges.

It is easy to dismiss excess charges as something that might never happen. And maybe for some people, it will not. But if you see specialists, have ongoing health needs, or travel regularly, the risk is real.

No one likes surprise medical bills, especially in retirement when your budget might be more fixed. Some of those excess charges can add up to hundreds, even thousands of dollars.

With all that said, protecting yourself is easy. With the right Medigap plan, those charges are covered. You can enjoy your retirement and feel secure in your healthcare coverage.

How do you make sure you are covered?

There is no one-size-fits-all answer for Medicare Supplement plans. Everyone’s health, budget, and needs are different, which is why working with a Supplemental Medicare agency in Northwest Indiana is the ideal choice. They can help you compare plans from different insurance companies, explain the options in simple language, and make sure you have coverage that works for you now and in the future.

Looking for a Supplemental Medicare Agency in Northwest Indiana?

If you are looking for a Supplemental Medicare agency in Northwest Indiana that can help you compare your Medigap options and make sure you are fully protected from Part B excess charges, Senior Care Insurance Services is here for you. Contact us today to schedule an appointment with our agents.