Medicare Part B Excess Charges - Should You Worry?Jun 14, 2021
With macro laws bringing many changes to Medicare Supplement insurance starting in 2020, there has been a lot of talk lately about Medicare Part B Excess Charges, so today I am going to dive into Part B Excess Charges, what are they? , how to spot them, and if there's anything you
shouldbe concerned about, so stay tuned. I'm Stephanie, I'm a licensed insurance broker and Medicare professional, and I create these short videos to answer some of my most frequently asked questions about Medicare so you can access Medicare
charges. They look scary, but are they really okay? If you've been looking into Medicare Supplement insurance, you may come across this concept of
excessive Part B
charges, especially if you're considering Medicare Supplement Plan n or Plan D, both of which are generally very good ones. but do not cover
excessMedicare Part B charges; in fact, if you look at this standardized Medicare chart, you can see that the only two Medigap plans that cover the excess charge These are plans F and G, so what exactly are the Part B excess charges?
Medicare? Medicare Part B excess charges may occur if you go to a provider that accepts Medicare patients but does not accept Medicare as payment in full and this is also called Medicare assignment so if a provider does not accept Medicare assignment , that means they don't accept the Medicare payment as payment in full and you may be billed for more than the Medicare payment amount. Those are called overcharges, now overcharges can only be up to 15%. above the Medicare-approved amount, and there are certain states where overcharging is completely illegal. Medicare providers can't bill them and those would be the states you'd see on the screen.
Our excess charges are common. that 96% of Medicare providers accept Medicare assignment, so they accept Medicare payment as payment in full, leaving only about 4% of Medicare providers that could essentially bill you for access charges and, in 2016, Aetna, which is one of the nation's largest insurance companies, released data indicating that more than 99% of the Medicare claims they process do not have excess charges and less than 1% do. of access. the average overage charge was less than $20, so while the thought of overage charges might seem scary when you look, data access charges are pretty rare and when they do happen they're usually pretty minimal, plus if You are considering a Medicare Supplement. plan that doesn't cover access charges, you'll want to know how to be proactive and check and see if your doctor accepts Medicare assignment up front and there's a pretty simple way to do that, it's pretty simple to check online and see if your provider accepts the
medicareassignment so we would just start here on the
medicare.gov website and on the left side of the screen we would scroll down to find doctors and providers. l scroll down to find doctors and other health professionals from here you can enter your location, your zip code and you can enter the name of a provider, a group of providers, you can enter a specialty like cardiologists in my area I'm just going to write dr.
You and Jones can see all the different providers in the area as long as there is a green check mark next to their name which means they accept assignment from Medicare, so this provider accepts Medicare-approved amounts and this means they will not be will bill you for any excess charges from this provider and as we scroll you can see most providers accept Medicare assignment they have that green check mark this is a great way to check and see if your doctor accept Medicare assignment if you are concerned about overcharges I prefer this search to calling the provider's office sometimes, depending on who you talk to at the front desk, they may not always have the most accurate information, it's always a good idea to use this lookup tool if you can, and double check to make sure your doctor accepts the Medicare-approved payment amount there are usually excess charges o and are a risk you take if you choose a Medicare Supplement Plan n or Plan D instead of Plan G or Plan F, but often the premium savings in a plan n or Plan D can be several hundred dollars. dollars a year, which may be worth it if you're comfortable with the small risk of overcharges when you're shopping for Medicare supplement insurance and are considering the possibility of potential overcharges.
It is always very important to stay informed and have the facts before making a decision. If you ever have any questions, please feel free to contact me by phone. or send an email. I am an independent broker, so I work with all the major traders across the country and my service is completely free. Thank you very much for seeing us. See you soon.
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