The short answer
A Part B excess charge is an extra amount a provider can bill above Medicare's approved rate when they don't accept Medicare assignment. It's capped by law at a small percentage over the approved amount, but it's a cost that can surprise you if your doctor bills it. Whether you ever encounter one depends on your providers and your state.
Some Medigap plans cover excess charges entirely, which removes the worry; others, like Plan N, leave them to you.
Who can bill excess charges
Providers who accept Medicare assignment agree to Medicare's approved amount as full payment, so they can't bill excess charges. Providers who don't accept assignment (non-participating providers) can bill up to the legal limit above the approved amount. In areas where most doctors accept assignment, excess charges rarely come up; in others, they can.
A few states limit or prohibit excess charges entirely, so location matters. If you're choosing between Medigap plans, this is one factor in the Plan G versus Plan N decision — our comparison of Plan N copays and excess charges covers it.
How to avoid them
Two simple protections: choose providers who accept Medicare assignment, and if excess charges concern you, pick a Medigap plan that covers them (such as Plan G). That combination means you won't face these extra bills.
For most people in most areas, excess charges are a minor issue — but knowing they exist helps you choose a plan and providers wisely. Our Medicare Supplement overview explains which plans include this coverage.
Frequently Asked Questions
What is a Medicare Part B excess charge?
It's an extra amount, capped by law, that a provider who doesn't accept Medicare assignment can bill above Medicare's approved rate. Providers who accept assignment can't bill it.
Which Medigap plans cover excess charges?
Plans like Plan G cover Part B excess charges in full. Plan N does not, leaving them to you. Whether that matters depends on your providers and state.
How do I avoid Part B excess charges?
Use providers who accept Medicare assignment, and if you're concerned, choose a Medigap plan that covers excess charges. Some states also limit or prohibit them.
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