Ever wonder if you really need Medicare Part B? For most people over 65 the answer is: Yes, you need to enroll in Part B and you should do so when first eligible. If you miss your Part B deadline, you could be subject to penalties. Check out our Medicare deadline Calculator here
When to enroll in Medicare Part B largely depends on whether you (or a spouse) has qualifying job-based or retirement insurance that can act in place of Part B. If so you may be able to waive Part B due since you have credible coverage through work. If you don’t have access to credible coverage from a work or spouse, it is usually recommended that you enroll in Medicare Part B when first eligible (age 65 for most people).
Even if you have retirement insurance, you may still have to enroll in Part B. Most retirement programs require it. Check with your HR team and confirm your situation. Make sure that if you waive Medicare Part B due to retirement insurance, that you are not subject to Part B penalties if you enroll later.
For those who have retirement coverage, You have 8 months to enroll in Medicare once you stop working OR your employer coverage ends (whichever comes first). If you do not enroll in Part B within 8 months of losing your coverage based on current employment, you may have to pay a lifetime late enrollment penalty and have a gap in coverage.
The monthly premium for Medicare Part B is $170.10. If you cannot afford it, Medicaid has programs to assist with payment. If you choose to forego this coverage and don’t have qualifying credible coverage insurance, you will also have to pay all out of pocket costs to see a doctor outside of a hospital situation (Medicare Part A covers hospitalization). On top of this if you decide to enroll late, you can be subject to the Part B penalty, which can really add up.
What Does Part B Cover?
Medicare Part B covers your out-patient medical expenses at 80% (you pay 20%) after you pay the $233 deductible, for such services as:
- Doctor visits
- Second opinion before surgery
- Lab costs
- Mental health out-patient services
- Mental health partial hospitalization
- Clinical research
- Preventive care
- Ambulance services
Other Medicare Options
If you are enrolled in Medicare Part A and Part B, you can choose to “replace” your coverage through a Medicare Advantage plan (MA) or keep Original Medicare and supplement it with a Medigap plan to fill in the gaps. Both options require that you enroll in Medicare Part B first.