What is a Limiting Charge?
In Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage., the highest amount of money you can be charged for a covered service by doctors and other health care suppliers who don’t accept Medicare-assignment is called a limiting charge. The limiting charge, commonly known as excess chargesA Medicare Part B excess charge is the difference between a health care provider’s actual charge and Medicare’s approved amount for payment., is 15% over Medicare’s approved amount. The limiting charge only applies to certain Medicare Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. and Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. services and doesn’t apply to supplies or equipment.