Do you need to know more about Medicare Part B excess charges? What it is and how it works. Should you be concerned if your coverage does not cover Part B excess charges. This article should help . . .
Medicare Part B Excess Charges
What are Medicare Part B excess charges? You may be doing some research about Medicare Part B excess charges and also may be considering a Medicare supplement plan that does not cover the Part B excess charges, for example, a Plan N. You want to know if this is an important thing to be concerned about. Should you be worried if your plan does not cover Part B excess charges?
When you receive medical care from a medical provider, if you go to a doctor, specialist or to the hospital, they’re going to ask you if you have Medicare coverage. You will say yes and provide them with your Medicare card. The medical provider may also ask you if you have any secondary coverage such as a Medicare supplement policy. You would then show them the ID card that you received from the insurance company that is providing your secondary coverage. Your medical provider will then send a claim to Medicare through software that is used to communicate with the Medicare system.
Most doctors accept what’s called – “Medicare assignment“. If your doctor accepts Medicare assignment, this means that they have agreed in advance to accept payment in full from Medicare and your secondary company.
If you have a provider that does not accept Medicare assignment. this means that they do not agree to accept payment in full in accordance to what Medicare would usually agree to pay them. If a doctor does not accept assignment, they are allowed to charge you in excess of up to 15% over and above the amount that Medicare has approved for the services that they have provided to you. This brings us to the most important question:
Does this happen very often and should you be concerned about having to pay Part B excess charges? The simple answer to that question is – NO!
This is honestly something that very rarely happens. The majority of doctors and medical providers that accept Medicare do accept assignment. One recent statistics shows that approximately 96% of Medicare providers do accept assignment.
We also recently received some statistics from Aetna, one of our major carriers and they did some research and they were able to show that in the year 2016, 99 % of the claims that they processed that were Medicare related, were sent through the system as a doctor who does accept assignment.
If you already have a Medicare supplement plan F or a Medicare supplement Plan G, your plan already pays for Part B excess charges. However, if you might be considering moving to a Plan N, this plan does not cover the Part B excess charges.
However, it is very rare that you’re going to have a situation where your Part B excess charges are not covered. Even if you were to experience a situation where your Part B excess charges are not covered, the previous report that I mentioned that was provided to us by Aetna, also reported that in the 1% of cases where excess charges were involved, the charge was less than $20.00.
It’s very unlikely that you are ever going to experience a Part B excess charge, and if you do it’s going to be a very reasonable and very affordable amount. Our recommendation is that you should not worry about Part B excess charges if you are considering a plan N.
In conclusion, the Plan F and Plan G Medicare supplement plans do cover Part B excess charges. If you have a plan F or a plan G now or you are thinking about getting a Plan G in the future, you don’t have to worry about Part B excess charges.
If you have a plan N now or you are thinking about getting a Plan N in the future, the Part B excess charges really are not a big concern that should be worried about. If you would like to explore the possibility of moving to a plan N to reduce the cost of your Medicare supplement monthly premium, I would be very happy to take a look at that option for you.
If you have any questions about this subject or would like to speak to us about any of your Medicare needs in regards to Medicare supplement, Medicare Advantage or Part D prescription drug plans, I would certainly be very happy to speak with you.
I am an independent agent specializing in the senior market. I would be very happy to look at your current coverage and compare it to the marketplace to make sure that you are still getting a good value. My services to you will always be FREE.
Billy Williams
800-499-1942
MedicareHealthInsuranceOptions.com
