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What are Excess Charges? Which states do not allow Medicare excess charges?


If you’re looking at purchasing a Medigap policy, you may find that some of the Medigap plans do not cover excess charges. Doctors who “accept Medicare assignment” have agreed to accept the Medicare approved amount as payment.  When a doctor doesn’t accept Medicare, excess charges may occur; doctors can only charge 15% above the Medicare approved assignment.  Always ask your doctor if they accept Medicare assignment.  Recent studies have shown that only about 5% of doctors do not accept Medicare assignment.  There are some states that do not allow Excess Charges:   

  • Connecticut 
  • Massachusetts 
  • Minnesota 
  • New York 
  • Ohio 
  • Pennsylvania 
  • Rhode Island
  • Vermont

Learn More: What is NOT covered by a Medicare Supplement (Medigap) plan?

People Also Read: What does a Medicare Supplement (Medigap) plan cover?


Meet Melissa MacCalla

Medicare is not simple and can be hard, frustrating, and downright confusing for most. I love when I get someone on the phone and I am given the opportunity to explain the difference in plans to them and have Medicare make sense. I enjoy talking to clients year after year, hearing about their families growing or them asking about mine.


Senior Healthcare Solutions, you truly stand out from most other insurance agents. Thank you so much for all of your help and I know that you will have nothing but success with how you conduct business.

Joan B.

Montgomery, AL

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