What are Medicare Part B excess charges, and how can I avoid them?

Question

Mike Alexander · Accepted Answer

Part b excess charges are applied qhen you go to a doctor who does not take medicare assignment. The excess charge is 15%.
You can avoid this by making sure your doctor takes medicare by asking them

Ann Sanfelippo · Answer

Medicare Part B excess charges occur when a doctor does not accept Medicare assignment and is allowed to charge up to 15% more than the Medicare-approved amount. You are responsible for paying that extra amount out of pocket.

You can avoid excess charges by choosing providers who accept Medicare assignment (they agree to Medicare’s approved rate). Another option is enrolling in a Medigap Plan G or Plan F, which covers these excess charges.

It’s less common in some states, but still important to verify your provider’s billing status before receiving care.

Edward MacConnell · Answer

Medicare part B eccess charges are balance billed over and above the Medicare allownce. Goint o providers who accept Medicare as payment in full will avoid these charges. Also a quality Medigap plan can help avoid them.

Answered by Edward MacConnell on April 13, 2026

Broker Licensed in PA, AK, AZ & 19 other states

Answered by Edward MacConnell Medicare Insurance Agent

Kristen Skinner · Answer

Well you have to pay a $202.90 premium first of all to have Part B. Which is unavoidable if you want full coverage besides hospital. And then the Part B deductible of $283 to pay before it starts to pay and 20% coinsurance overall. The best idea or plans to avoid the excess charges are a Plan G or Plan N. Plan G will pay 100% after the you pay the Part B deductible. PLan N is similar, however, you could incur a small $20 doctors copay or an ambulance copay of $50. Medicare Advantage covers the extra 20% out of pocket with small copays, and often includes free dental, vision, and hearing aid help.

Answered by Kristen Skinner on April 13, 2026

Broker Licensed in OK

Answered by Kristen Skinner Medicare Insurance Agent

Pauline Weiland · Answer

Those charges are not common. For me personally, I have never encountered anyone that's had one. It only applies with Original Medicare and supplements. When a provider does not participate in Medicare program, provider can charge an excess of 15%.

Answered by Pauline Weiland on April 13, 2026

Agent Licensed in AZ, CA, MS, NV & TX

Answered by Pauline Weiland Medicare Insurance Agent

William Brobson · Answer

Excess charges are the charges that Medicare will allow a Doctor that does not accept Medicare to charge 15% over what Medicare allows.  To avoid these charges, go to a Doctor that accepts Medicare.

Jack Mayer · Answer

Part B excess charges are above and beyond what Medicare says is fair price, but if you ask the provider to except what Medicare says is fair and reasonable then you would be asking for an assignment to avoid the excess charges. If you have a Plan G for example (Medi-Gap policy) then the excess charges are paid in full.

Answered by Jack Mayer on April 20, 2026

Agent Licensed in CA & NV

Answered by Jack Mayer Medicare Insurance Agent

Dean Chiapetto · Answer

Doctors and hospitals have the legal right to add up to 15% to your bill over what Medicare approves. So if Medicare approves $1000, you could be charged the 20% part B co insurance and an extra 15% in excess charges. You would pay $200 + $150 = $350 and Medicare would pay $800. So it is not 80%/20%. 
If you have a Medicare Advantage plan currently there is no worry about this. If you have a Medicare Supplement/Medigap Plan, Plan F & G will cover the excess charges.
Meet with a local broker.
Brokers Make a Difference.

Brooke Smith · Answer

Medicare Part B excess charges are charges that occur with a doctor or facilty that does not accept Medicare Assignment. You can avoid these by making sure your doctor or facilty accepts Medicare assignment. There are some policies that can protect you against Medicare Part B excess charges.

Answered by Brooke Smith on April 13, 2026

Agent Licensed in UT, CA, ID, NV, OR & WY

Answered by Brooke Smith Medicare Insurance Agent

Elizabeth Holly · Answer

Excess charges are what the provider charges above and beyond the published coverage amount for a service. You can avoid these charges by asking if the provider accepts Medicare assignment. If they do not, work with your agent to find a provider that will.

Answered by Elizabeth Holly on April 13, 2026

Broker Licensed in AL

Answered by Elizabeth Holly Medicare Insurance Agent

What are Medicare Part B excess charges, and how can I avoid them?

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What are Medicare Part B excess charges, and how can I avoid them?

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