Confused about Medicare Part B?

What is Medicare Part B and what does it cover?

Medicare Part B is the Medicare Advantage option that focuses on outpatient medical/surgical services and supplies, including doctors’ services, diagnostic tests, outpatient therapy, and outpatient mental health services.

Some preventive health care services are covered as well, including: a one-time “Welcome to Medicare” visit, annual wellness/physical exams, common shots/vaccines, and smoking cessation. Various screenings and tests are also covered, including: abdominal aortic aneurysm screening, bone mass measurement, cardiovascular disease screenings, colorectal cancer screenings, diabetes screenings, EKG screening, glaucoma tests, HIV screening, prostate cancer screening, pap tests, pelvis exams, clinical breast exams, and mammograms.

Who is eligible for Medicare Part B?

Medicare Advantage and Medicare Supplements, including Medicare Part B, are health insurance options for three groups of people:

people 65 years and older
people under 65 years with certain disabilities
and people of any age with End-Stage Renal Disease.

These groups of people should enroll in Medicare Part B if they:

are without coverage from active employment (or spouse employment)
have group coverage for fewer than 20 employees (Medicare is primary in this case)
have individual health coverage
or have COBRA.

When can I enroll in Medicare Part B?

When first signing up for Medicare Part B, the Initial Enrollment Period begins three months before the beneficiary turns 65 and continues three months after. Beneficiaries are encouraged to sign up early to ensure coverage begins the month of their 65th birthday; waiting could delay the coverage start date 2-3 months.

If the beneficiary already receives Social Security, Railroad Retirement, or disability benefits, Automatic Enrollment will be processed to begin the month they turn 65. The beneficiary must opt out if they don’t want to be enrolled.

Beneficiaries who are not auto-enrolled and who do not sign up during the Initial Enrollment Period may sign up during the Medicare General Enrollment Period, which is January 1st to March 31st each year. Signing up in the General Enrollment Period generally means the beneficiary will pay more (see next section on delaying enrollment). Some people may also qualify for Medicare’s Special Enrollment Period in certain circumstances, including loss of coverage.

Can I delay enrolling in Medicare Part B?

A late enrollment penalty for Medicare Part B can occur if members do not sign up when first eligible (in the Initial Enrollment Period). The penalty is 10% more paid for each full 12-month period that the member was eligible but not enrolled, and this penalty may have to be paid as long as the member has Medicare Part B. Typically, there are no penalties for those who sign up during a special enrollment period, including those with proof of creditable coverage until the time of coverage by Medicare Part B.

How much does Medicare Part B cost?

To determine the cost of your 2021 premium for Medicare Part B, find your 2019 income on the chart below. Note that individual and joint tax return numbers are listed in separate columns.

Key Takeaways

If you are eligible for Medicare Part B, don’t wait to get enrolled! Sign up as early as possible during the Initial Enrollment Period to ensure coverage is not delayed and no penalties are added to your payments.

Contact a local agent with any questions about Medicare Part B, or any questions you have about Medicare Advantage or Medicare Supplements.

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About Utah Avenue Insurance

Utah Avenue Insurance is your local health insurance experts. Our agents are here to help you with all your health insurance questions. Utah Avenue can help you with marketplace (aka Obamacare) plans, private health insurance and Medicare. If you have questions about how your medical insurance plans work or need help enrolling in a plan, we can help you. As always, our service is free to you.