Key Takeaways
- In many states a provider may bill up to 15% above the Medicare-approved amount.
- There is no cap on the excess charges you could owe out of pocket.
- Some Medigap plans (like Plan G) cover Part B excess charges.
Excess charges are the amounts a provider is allowed to bill above and beyond what Medicare approves for a service. In many states, providers can add up to 15% on top of the Medicare-approved rate.
There is no cap on this out-of-pocket exposure — though certain Medigap plans, such as Plan G, cover Part B excess charges.