Medicare Part B
Baren Associates
Medicare Part BMedical Services
Coverage Basics
Medicare Part B coverage includes your doctors, tests and durable medical equipment (such as CPAP machines).
You are eligible to enroll in Part B when you turn 65 and the best time to enroll is during your 7 month Initial Enrollment Period
(IEP). A delay in enrolling in Part B could mean a gap in coverage and a lifelong Late Enrollment Penalty.*
While Medicare Part A is free to most people, Medicare Part B
does have a monthly premium. The amount is on a sliding scale based upon your income.† The least you'll pay for Part B is $174.70 per month. However, if your income is high enough, the premium could be as much as $419.30 per month. If you get Social Security benefits, premiums are deducted from your monthly check.
Other Part B Costs
In addition to its monthly premiums, Medicare Part B has a yearly deductible of $240. You are also responsible for a 20% co-insurance payment. During a particularly bad year, this could add up to a sizable amount out of pocket.
Could You Wait?
Medicare Part A has no premium so there is no reason not to enroll as soon as possible when you are turning 65.
Medicare Part B
does have a monthly premium. So, if you are working and you are covered by a Group Health Plan** at work, you can hold off enrolling in Part B until both conditions are no longer true (working and
covered by a group plan). Then, you need to enroll.
Your Special Enrollment Period
(SEP) begins once you no longer meet both conditions. You will have 8 months to enroll in Medicare Part B without incurring a late Enrollment Penalty. However, coverage doesn't start immediately and there may be a gap in coverage of 1 to 3 months. Best to plan ahead and COBRA doesn't count.***
Additional Coverage
Again, there is the potential for sizable out of pocket costs and again, the solution to manage your costs is a
Medigap Plan. The same Plan that covers your Part A gaps will also cover the gaps in your Part B coverage.
You should be thinking about enrolling in a Medigap Plan when you enroll in Medicare Part B. There are currently 11 standardized Medigap Plans to choose from. We can assist you in selecting the most cost effective Plan that best fits your needs.
*The penalty for late enrollment in Part B is an additional 10% for each 12-month period that you delay enrolling.
**The Group Health Plan must include at least 20 employees to be eligible.
***COBRA
is a regulation that allows you to keep the same health insurance after you leave your employment. It lasts for as long as 18 months. For purposes of calculating your Special Enrollment Period,
the time you spend on COBRA is irrelevant. Your 8 month window begins when you leave your employment.
†Medicare Part B (as well as Medicare Part D) are subject to a possible Income Related Monthly Adjustment Amount (IRMAA), which is based upon your income.