Medicare Part B

To be eligible for Medicare Part B, you must be 65 years of age or qualify due to a disability. Part B is optional but you could be penalized if you choose to delay enrollment. However, if you have medical insurance through an employer, you don’t have to enroll in Part B.

What is Medicare Part B?

Part B covers medical services. It helps pay for Doctor’s Services, Hospital Outpatient Care, Home Health Care and some Preventive Care Services.

How much is the Part B premium?

The standard monthy premium in 2020 is $144.60. Most people pay the standard premium amount. People with high income may have a higher Part B Premium. If you receive Social Security benefits, the payment is deducted from your monthly check. Otherwise, you need to send a monthly premium payment to Medicare.

Part B Deductible

In 2020, the Part B Deductible is $198.

What does Medicare Part B cover?

In addition to doctor visits, Part B covers outpatient surgical procedures, diagnostic tests, lab work and much more.

How much does Medicare pay?

For most services, Medicare will pay 80% once you meet the Part B Deductible. You would be responsible for 20% co-insurance.

Part B Co-insurance

After the Part B deductible, most Medicare Supplement Plans generally pay 20% of Medicare eligible expenses for physician’s services, hospital outpatient services and supplies, physical and speech therapy, and ambulance service. Plan N requires the insured to pay a co-payment of $20 for each covered office visit, including specialists, and up to $50 co-payment for each covered Emergency Room (ER) visit. However, the ER co-payment will be waived if admitted to any Hospital and the ER visit is covered as a Part A Expense. Plan K pays for 50% of co-insurance and Plan L pays 75% of co-insurance.

Medicare Part B Enrollment Periods

You can sign up for Medicare Part B during the following enrollment periods:

The Initial Enrollment Period(IEP) is a 7 month period. It begins 3 months before your 65th birthday. It includes the month of your 65th birthday and lasts for 3 months after your birth month. You should automatically be enrolled if you are under 65 and eligible for Medicare because of a disability.

The General Enrollment Period(GEP) occurs from January 1 and March 31 of each year. You can enroll in Medicare Part B for the first time during this time period. If you enroll during this time period and it is after your IEP, your coverage will begin on July 1.

There is a Medicare Part B late enrollment penalty. For each 12 month period that you delay enrollment in Part B, you will have to pay a 10% Part B premium penalty.

The Medicare Part B Special Enrollment Period(SEP) allows you to enroll in Part B. You can use the Part B SEP while you have employer group insurance, or for eight months after you no longer have employer group insurance.

In order to be eligible for it, you also must have been
continuously covered by insurance from current work or by Medicare Part B since becoming eligible for Medicare (including the first month you became Medicare-eligible). If you have had more than eight consecutive months without coverage from either current work or Part
B, you are not eligible for the Part B SEP.

How do I enroll in Medicare Part B?

You can enroll for Part B on the Social Security website. You can also visit your local Social Security office. In addition, you can call Social Security at 1-800-772-1213. If you are a railroad retiree, you can call the Railroad Retiree Board at 1-877-772-5772.