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Medicare Supplement Insurance Fights Part B Excess Charges

If you’re like most Americans (according to surveys), you may not know much about Medicare.  Needless to say, you probably hadn’t even heard of “Part B Excess Charges,” much less understood how much they can cost you.  It turns out that there really are a lot of holes in Medicare’s coverage.  That’s why Medicare Supplement Insurance Plans are a booming business.

Medicare Part B coverage is full of very costly gaps.  The $155 dollar annual deductible doesn’t sound so bad, and, of course, you have to pay a monthly premium for Part B.  The penalty for late enrollment does sound a bit unnecessary – after all, this is supposed to help seniors get the medical care they need, right?  After the deductible has been met, Part B handles physician services and supplies, clinical laboratory services and outpatient hospital treatment.  Here’s the catch – it only pays for 80% of those bills at the Medicare-approved amount.  Fortunately, every Medigap Plan pays the remaining 20 percent that Medicare does not cover, but they pay 20 percent of the Medicare-approved amount.

The Medicare-approved amount could actually be the biggest hole in Part B coverage.  So, what happens when a provider charges more than the Medicare-approved amount?  Here’s an example: Let’s start with a $1,000 doctor bill.  The Medicare-approved amount for that procedure is $800 and Medicare pays 80% of $800 or $640. Then your Medigap Plan pays 20% of the $800 Medicare-approved amount or $160.  Your doctor, however, billed $1,000, so you still owe $200 ever after both Medicare and Medigap have paid.  That’s called Part B Excess Charges.

Fortunately, there are a couple of Medigap Plans that can protect you from Part B Excess Charges.  Plan F pays 100% of Part B Excess Charges, and Plan G pays 80% in exchange for premiums that are slightly lower than those of Plan F.

How can you stay on top of all this to protect yourself against unnecessary losses due to gaps in your Medicare coverage?  MediGap Advisors at has lots of ideas to help seniors save money on Medicare gaps, prescription costs and lab tests.  There you can even find out how to reduce your hospital bill after you leave the hospital.  And, that’s something almost everyone could use!

Jim McFadden has over 11 years of executive-level experience in the health insurance industry, is a youth baseball, softball and football coach, and has one of the worst fantasy football records in the world.


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