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GLOSSARY · MEDICARE

Part B Excess Charges

Up to 15% above Medicare-approved amounts — only allowed in some states; covered by Plan G but not Plan N.

Medicare 📋 Reviewed by InsureCo Editorial Team · Updated April 30, 2026
Quick definition: Up to 15% above Medicare-approved amounts — only allowed in some states; covered by Plan G but not Plan N.

Full explanation

Part B excess charges occur when a non-participating Medicare provider bills you up to 15% above Medicare's approved amount. Most providers accept Medicare assignment (no excess), but some specialists do not. Eight states ban excess charges entirely (CT, MA, MN, NY, OH, PA, RI, VT). Medigap Plan G covers excess charges; Plan N does not. If you live where excess billing is rare and rarely see specialists, Plan N's lower premium typically wins; in excess-billing states with frequent specialist visits, Plan G's protection is worth more than the premium savings.

Related terms

Medigap Plan G Medigap Plan N Medigap Medicare Part B

📎 Primary source: official source

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