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Medicare Part B Excess Charges Explained: What You Need to Know
Last Modified: 10/05/2026 | Reviewed by Keith Armbrecht (NPN 634015)
Quick Summary
A Medicare Part B excess charge is an additional amount that certain healthcare providers may legally charge above the Medicare-approved amount when they don’t accept Medicare assignment.
Excess charges apply only in certain situations.
Medicare Supplement Plan G covers Part B excess charges, while Plan N doesn’t.
Understanding how assignment works can help you avoid unexpected costs.
Key Facts
- Excess charges relate to Medicare Part B services.
- They can occur when a provider doesn’t accept Medicare assignment.
- A provider who accepts assignment agrees to accept Medicare’s approved amount as payment in full for covered services.
- Providers who don’t accept assignment may be allowed to charge above the Medicare-approved amount.
- Medicare rules limit the amount non-participating providers can charge.
- Plan G covers Part B excess charges.
- Plan N doesn’t.
- Some states have additional protections that restrict or prohibit excess charges.
- Asking whether a provider accepts Medicare assignment can help you avoid excess charges.
What Does “Accept Assignment” Mean?
A provider who accepts Medicare assignment agrees to:
- Accept the Medicare-approved amount
- Receive Medicare’s payment directly
- Charge you only the applicable Medicare deductible and coinsurance
That means you don’t face an excess charge from that provider for a Medicare-covered service.
What Happens If the Provider Doesn’t Accept Assignment?
A provider who doesn’t accept Medicare assignment may, in certain circumstances, charge more than the Medicare-approved amount.
The difference between the Medicare-approved amount and the legally permitted higher charge is called an excess charge.
A Simple Example
Assume a Medicare-approved amount for a Part B service is:
$100
A non-participating provider may legally be permitted to charge more than that amount under Medicare’s limiting-charge rules.
If your Medigap policy covers excess charges, the policy can help pay that difference according to its benefits.
Plan G vs. Plan N
Plan G
Covers Part B excess charges.
Plan N
Doesn’t cover Part B excess charges.
This is one of the differences between the two plans.
Should Excess Charges Stop You From Choosing Plan N?
Not necessarily.
The better question is whether the premium savings on Plan N justify accepting the potential exposure.
You can also ask healthcare providers whether they accept Medicare assignment before receiving non-emergency services.
Video Explanation from Keith
Medicare Excess Charges Explained
Keith's Take
Excess charges get much more attention than they probably deserve in many Plan G vs. Plan N discussions.
Yes, Plan N doesn’t cover them.
But I don’t think that fact alone automatically makes Plan G better.
I want to know:
How common are excess charges where you live?
Do your doctors accept Medicare assignment?
and most importantly:
How much money are you saving on Plan N?
If you’re saving hundreds of dollars every year, the overall comparison may still favor Plan N.
Keith Armbrecht
Medicare on Video
Frequently Asked Questions About Medicare Excess Charges
Q. What is a Medicare excess charge?
A. It's the difference between Medicare's approved amount and a higher amount a provider may legally charge when the provider doesn't accept assignment.
Q. Can every Medicare doctor charge an excess charge?
A. No.
Q. What does accepting assignment mean?
A. The provider agrees to accept Medicare's approved amount as full payment for the covered service.
Q. Does Plan G cover excess charges?
A. Yes.
Q. Does Plan N cover excess charges?
A. No.
Q. Can I ask my doctor whether they accept assignment?
A. Yes, and this is a good question to ask before receiving non-emergency services.
Q. Do excess charges apply to Medicare Part A?
A. Excess charges are associated with Medicare Part B professional services.
Q. Are excess charges allowed in every state?
A. Are excess charges allowed in every state?
Official Government Sources
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