Medicare Part B Information

Medicare Part B is considered to be the medical insurance portion of the health program. Under Medicare Part B, beneficiaries will be able to have portions of their doctor and outpatient services covered. Certain preventative services and durable medical equipment (DME) are also covered under Part B. Most individuals may be automatically enrolled. However, there are certain periods during the year in which someone can enroll. For a monthly premium and yearly deductible, Medicare beneficiaries will be able to receive coverage under Medicare Part B.

Coverage

Medicare Part B helps to cover medically necessary and preventative services for beneficiaries. Beneficiaries can receive coverage for services such as chiropractic visits, emergency room visits, eye exams, foot exams, and home health services. Part B also helps to pay for any DME that a beneficiary might need. The types of DME that may be covered are diabetic supplies, eyeglasses, hospital beds, oxygen and wheelchairs. For most services and equipment, the beneficiary will have to pay 20 percent of the Medicare-approved amount.

Costs

Beneficiaries are required to pay a monthly premium and an annual deductible for their Part B coverage. If a beneficiary is enrolled in Part C or a Medicare Advantage Plan, their plan may already cover the premium payment. The monthly premium may be higher for some under certain conditions. If the beneficiary is single, filed an individual tax return, and if their adjusted gross income exceeds a specified amount, they could pay more. The same holds true if the beneficiary is married, filed a joint tax return, and had an adjusted gross income greater than a specified amount. Those individuals who may have to pay a higher premium will be notified by Social Security. If a beneficiary has low income, he may be eligible to receive assistance paying the premiums.

Who Can Enroll

If an individual receives benefits from Social Security or the Railroad Retirement Board (RRB), then they will receive Part B coverage beginning the first day of the month that they turn 65. If an individual is disabled but is younger than age 65, they will receive Part B coverage after they have been receiving Social Security or RRB disability payments for 24 months.
All new beneficiaries will receive their Medicare card in the mail 3 months before they turn 65 or when they receive their 25th month of disability payments. If an individual does not want the Medicare Part B coverage, they will have to follow the instructions included with the card and mail the card back. If they choose to keep the card, they will have to pay the Part B premiums.

When to Enroll

For those who did not sign up for Medicare Part B when they first became eligible, there are enrollment periods during the year. The first is the general enrollment period which is held January 1 through March 31. If an individual signs up during this time, their coverage will begin July 1 of that year.
The special enrollment period is for those individuals who may have waited to enroll in Part B because they or their spouse is working and has health coverage. Individuals can enroll in Part B anytime while they have employer-provided health coverage, or during the 8-month period immediately following the termination of their employment or employer-provided health coverage.
There is also a special enrollment period for those who volunteer internationally. This is for individuals who have waited to sign up for Part B because they already had health insurance coverage while they were volunteering in a foreign country. These individuals will be able to enroll during the 6-month period immediately following the end of their volunteer work or the termination of their health coverage outside the United States.

Late Enrollment Penalty

If a beneficiary does not enroll in Medicare Part B when she is first eligible, there may be a 10 percent increase in her monthly premium. This will be for each full 12-month period that she could have had Part B, but did not enroll. However, if the beneficiary did not sign up for Part B because she or her spouse is working and has other health coverage, she may not have to pay the increased premium.