If you’re like most people, you probably hadn’t even heard of Part B Excess Charges, much less understood how much they can cost you. Like most Americans (according to surveys), I didn’t know much about Medicare. It turns out that there really are a lot of holes in Medicare’s coverage. That’s why almost everyone who has Original Medicare signs up for a Medicare Supplement Plan.
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.
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 to find out more? At www.MediGapAdvisors.com we have a lot of information and ideas to help seniors save money on Medicare gaps, prescription costs and lab tests.
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