Shedding Light on Medicare Part B

Medicare Part B is available for anyone eligible for Medicare, but some individuals choose to enroll immediately, while others decide to wait. Understanding the Part B benefits and coverage can help you make this decision. Part B helps cover medically necessary services that are not included in Part A benefits, such as like doctors’ services, outpatient care, home health services, other medical services, as well as some preventive services to help maintain your health and to keep certain illnesses from getting worse. If you sign up for Part B, you will have to pay a monthly premium for these benefits.

If you already have Medicare and are wondering if you have Part B, you can check your Medicare card to find out. If you are not eligible for Medicare yet, when can you get Part B? In most cases, if you are already getting benefits from Social Security or the Railroad Retirement Board (RRB), you will automatically get Part A and Part B starting the first day of the month you turn 65. If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month. If you are under 65 and disabled, you automatically get Part A and Part B after you get disability benefits from Social Security or certain disability benefits from the RRB for 24 months. You will get your red, white, and blue Medicare card in the mail 3 months before your 65th birthday or your 25th month of disability.

It is important to note that if you do not want Part B, you should follow the instructions that come with the card, and send the card back. If you keep the card, you keep Part B and will pay Part B premiums.

If you are not getting Social Security or RRB benefits (for instance, because you are still working) and you want Part A or Part B, you will need to sign up (even if you’re eligible to get Part A premium-free). You can sign up for Part B when you are first eligible for Medicare during your 7-month Initial Enrollment Period. For example, if you are eligible for Part B when you turn 65, your initial eligibility period spans a 7-month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65.

If you do not sign up for Part B when you are first eligible, you can sign up between January 1 – March 31 each year, and your coverage will begin July 1. You may have to pay a higher premium for late enrollment. If you do not sign up for Part B when you are first eligible, you may have to pay a late enrollment penalty for as long as you have Medicare. Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn’t sign up for it. Usually, you don’t pay a late enrollment penalty if you meet certain conditions that allow you to sign up for Part B during a special enrollment period.

How much will Part B cost? If you choose to sign up for Part B, most people will pay a standard monthly premium. However, if your modified adjusted gross income as reported on your IRS tax return from 2 years ago (the most recent tax return information provided to Social Security by the IRS) is above a certain amount, you may pay more.

Why wait to enroll in Part B? There are situations in which you might choose to delay signing up for Part B. For example, if you or your spouse (or family member if you are disabled) is still working and you have coverage through an employer (including the Federal Employee Health Benefits Program) or union, contact your employer or union benefits administrator to find out how your insurance works with Medicare. It may be to your advantage to delay Part B enrollment.

You may need to enroll in Part B in certain circumstances. If you enroll in a Medicare Advantage Plan, you will need to have Part and Part B.  If you have Part A and TRICARE (coverage for active-duty military or retirees and their families), you must have Part B to keep your TRICARE coverage. However, if you are an active-duty service member, or the spouse or dependent child of an active-duty service member, you do not have to enroll in Part B to keep your TRICARE coverage while the service member is on active duty. Before the active-duty service member retires, you must enroll in Part B to keep TRICARE without a break in coverage. You can get Part B during a special enrollment period if you have Medicare because you’re 65 or older, or you’re disabled.

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