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Do You Need Medicare Part B?

Read this to learn if you really need Medicare Part B

by Katie Banks+ on Nov 06, 2019 | 26 Comments

Ever wonder if you really need Medicare Part B? For most people over 65 the answer is yes.  Read on to learn about the exceptions to the rule.

Article updated in November 2019 to reflect new information.

Enrolling in Medicare Part B depends on whether you have qualifying job-based or retirement insurance that can act in place of Part B, if you don’t it is suggested that you enroll. The monthly premium for Medicare Part B of $144.60. If you choose to forego this coverage and don’t have qualifying insurance, you will 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 are subject to 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 $198 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.

Conclusion
Medicare Part B can save you a lot of money in out of pocket costs by enrolling. Remember the only real reason you should choose not to enroll is if you have coverage through a qualifying source. If financially you have an issue paying the Part B premium Medicare can offer help. For further questions about Medicare Part B call the number above or
contact Senior65.

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Reader Comments and Questions

Click Here if you have a question

By Pamela on September 29, 2019

My husband and I are 70. We have part A and B in MEDICARE. We also have a GAP policy that goes up each year. Now it is 170 a month for each of us. My husband just returned back to the Electrical Union and they provide Health insurance for both of us. Should we keep Part B while he is working full time. If he only works two or more years, we think we should keep the GAP insurance because it would be too much money and he might not qualify for it later. We are paying for Part B, and the GAP policy. The GAP only pays if you have Part A and B. But he cannot work, we would need to put Medicare in first position. Now it is in second position. Should we keep our GAP insurance to stay protected? Thankyou. Pamela

Pamela,
If your husband accepts the health insurance provided by the company, when he retires you both will get a special enrollment period to get a Medigap plan once again with no health questions asked.

You should check our article on What if I have Medicare then return to work? to learn more.

Once you decide to enroll again in Medigap, give us a call. We charge nothing for our services.
-Michelle from Senior65.com


By Wanda on September 17, 2019

I am going to be on Medicare A & B starting November 1st. Do I need to get more coverage? I feel that might be enough but need to get educated. Thanks for you help.

We say "yes! you need more." At a minimum a $0 premium Medicare Advantage plan or at least a Part D drug plan. The best place to get started is to visit our Medicare Insurance page.
-Chris from Senior65.com


By Gary on September 10, 2019

I have signed up for Medicare A and B. My payment becomes due on 9/25/19 but I also am covered under my wife's work insurance. Can I delay my Plan B till I do not have insurance coverage under my Wife's Plan.? will there be a late signup charge when i decide to sign up for Part B?

Gary,
You can (and should!) delay your Part B until your coverage on your wife's plan ends. You will get a Special Enrollment Period to enroll in Part B, Medigap, Drugs and Medicare Advantage.There will be no penalty for delaying Part B when you have credible coverage from your wife's plan.

When the time comes, give us a call to get you enrolled. We charge nothing for our services.
-Michelle from Senior65.com


By Rose on September 07, 2019

I plan on retiring in December and have Medicare Part A and plan on acquiring additional insurance, Medicare Advantage. Do I still need to apply for Medicare Part B? I do not want to be over insured.

Rose,
In order to enroll in a Medicare Advantage plan, you do need to first get Medicare Part A and B. We can help you enroll at no additional cost to you. Give us a call when the time comes.
-Michelle from Senior65.com


By Norma on August 01, 2019

I turned 65 in November of 2018. I am still employed. I started getting Medicare A and B January 1st, 2019. However, i couldn't afford part b, so they cancelled it May 31st, 2019. Is there anything I can do to get a secondary insurance to help with my doctor visits and hospital appointments. I don't qualify for medicaid.

Norma,
Unless you have coverage via work, we know of no other options. We strongly recommend getting your Part B reinstated and then consider getting a Medcare Advantage zero premium plan to protect you. While it may be hard to afford Part B premiums, going with no coverage could most likely be much more expensive.
-Chris from Senior65.com


By Jody on July 14, 2019

I have received Medicare A and B for the last ten years when I became totally disabled. Can I get Gap or supplemental insurance? or is it too late?

Jody,
If you are in the 9 month period between the 3 months before your 65th birthday and the 6 months after, you can get supplemental insurance with no health questions asked and are guaranteed to be approved.

If that is not your case you can still apply going through medical underwriting. Give us a call to discuss.
-Michelle from Senior65.com


By Fred on July 12, 2019

I'm working full time and have already signed up for Medicare Part A. I'm planning on leaving my job the end of September. How long will it take and how soon should I apply for Medicare Part B?

Fred,
You can apply for Part B up to three months before your Part B Effective Date which would likely be on October 1st since you are leaving your work in September.

Once you get Medicare Part B, we can get you enrolled in either Medigap, Part D or Medicare Advantage. There is no cost for our services.
-Michelle from Senior65.com


By Kay on May 29, 2019

My mother was accepted by Medicaid for her nursing home costs, dose she need to keep Medicare part B? Arkansas stopped paying her part B medicare and now she has to pay $135.50 from her SS check. That amount was included in her co-pay for the nursing home. She is not financially able to make up the difference for this extra charge to her.

Hey Kay,
You will have to contact Medicaid with your specific question.
-Chris from Senior65.com


By Bettyjo on May 02, 2019

I plan on retiring on August 16, 2019. I currently have part A and employer health coverage, but now I need to apply for part B...how do I accomplish this. Also, I would like part B to be effective 09-01-19

Bettyjo,
You will want to start the special enrollment process for your Medicare Part B a few months before your desired start date. Medicare should allow you to pick your start date in the future so you can time it to match when your work coverage ends. To apply for Part B go to our Medicare page, scroll down to "I have already turn 65" and click on "Sign up for Medicare."

After you enroll in Medicare you will probably want to get a Medigap Plan (Medicare Supplement), Part D drug plan or a Medicare Advantage plan. We can help you enroll and we charge nothing for our services so please give us a call!
-Michelle from Senior65.com


By Donna on March 27, 2019

Do I need part b if I have medicaid

Donna,
No. You don't need Part B to be on Medicaid. There are some people who qualify for both Medicaid and Medicare Part A and/or Part B. They are known as “dual eligible.” If you are dual eligible, you can enroll in a Medicare Savings Program (MSP). Also run through Medicaid, MSPs will offer additional assistance by paying your Medicare Part B premium.
-Chris from Senior65.com


By LeAnn on March 26, 2019

My husband (age 69) is covered under my health insurance. As of June, I will be retiring (age 60). I will be keeping my family insurance (I also have a dependent on it for one more year- our son, age 25), but was told my husband now needs to pay for Medicare Part B in addition to our family insurance plan which includes prescriptions. Do I have any options?

LeAnn,
Some group insurance plans require Medicare eligible spouses to have both A and B. If this is the case, he may be better off leaving your company coverage and getting a Medigap or a Zero=Premium Medicare Advantage plan. Give our office a call and we can discuss.
Chris at Senior65.com


By petrica on March 13, 2019

I recently turned 65. Medicare is being taken out of my social security check. My social security was $743, but now it's down to $608. Is there any assistance I can get in helping to pay the $135 that's coming?out of my check. It's kinda hard to live on $608 per month.

Hello Petrica,
We are sorry to hear that. You can learn about assistance for Medicare here.

-Senior65.com Staff


By Teresa on January 25, 2019

I have medical coverage through the VA, do I need Medicare Part B

Hello Teresa,
Thank you for your service to our country! It is strongly recommended that all veteran seniors enroll in Medicare Part B. There is typically a monthly fee but it is usually worth it. The VA highly recommends that you enroll in Part B as well. Please see our article on Medicare and Vets here

-Chris from Senior65.com


By Phil on January 20, 2019

Am 66 enrolled in medicare A last year 2018 "A" only I am still working full time with great medical through employer I applied for SS Jan 13 as I turned 66 on Jan 5th. I understand I can wait to apply for Medicare "B" without penalty while I have my current insurance Is that correct? And are Medicare payments "B" individual or spouse is included? thanks

Hi Phil,
If you have creditable coverage via an employer, you can often keep it and postpone your Medicare part B. You will have a special enrollment when you leave your work coverage which will allow you to enroll in Medicare Part B, Medigap and a Medicare Part D drug plan.

Part B payments are individual. If you have questions on how everything works with your spouse give us a call.

Once you enroll in Medicare Part B you will probably want a Medigap Plan (Medicare Supplement) to cover the remainder of what Medicare does not cover. When the time comes, please give us a call and we would love to help you enroll in Medigap.

-Chris from Senior65.com


By Patricia on November 23, 2018

i have an HMO. At one point I was told I did not need part B or other medicare coverage (except A) because the coverage would be the same with the HMO. ??

Patricia,
We need more information before we can answer this question. In general if you are over 65 but still have coverage via work, you may be able to forgo part B.

If the HMO plan you have is actually a Medicare Advantage plan that would be different. You must first sign up for Medicare part A and B


By Victor on July 08, 2018

I am turning 66 and still working - the question is - if I stopped working do I have to get medicare part b or can I still delay if my spouse covers me with her insurance?
Victor
If you have coverage via a spouse you can typically delay enrolling in Medicare Part B. Confirm this with your spouse's HR department.


By Mark on September 06, 2017

I turn 65 in January. I qualify for Medicare Part A for free but don't want to sign up and pay for Part B since I am very healthy. I currently have insurance with CHM (Christian Healthcare Ministry), for $40 a month. If I hold on to that health plan, will that protect me from the annual 10% penalty that would otherwise be imposed for waiting, say 5 to 10 years before I think that Medicare Part B may be beneficial for me?

Mark,
The answer is maybe. You need to see if your coverage with CHM counts as qualifying insurance. If it does, then you will not have to purchase part B at this time and would avoid penalties when you join Part B later. Most health insurance coverage through work is considering qualifying coverage. Since we are unfamiliar with CHM please Contact the Center for Medicare Services to confirm.
-Chris from Senior65.com


By Pat on July 30, 2017

I am a Veteran living overseas where there is an American VA facility. Since my medicare Part B is no goid overseas and I have the VA do I need to be enrolled in Part B?

Pat,
That depends. Do you have other creditable coverage (not including the VA)? If so, no you do not need to enroll. If you don't, do you plan on coming back to the States? If so, you'll probably want to enroll now. The reason is, if you delay Part B without creditable coverage, you only have one time of year to apply: General Election Period (Jan 1 -March 31), and your plan will not begin until July. You will also owe a late penalty. For further questions, you will want to contact Medicare directly. Best of luck!
-Amy from https://www.senior65.com/


By Linda on April 15, 2017

I receive SSDI & will be turning 65 June 5. I have medicare A and full medicaid & have been automatically in enrolled in part B effective June 1, 2017. I've had full medicaid since 2009 & elected not to take part B at that time. Now that im automatically enrolled in part B with full medicaid, will i have to pay a late enrollment penalty?

Linda,
If you had creditable coverage and delayed Part B, you would not owe a penalty. If you did not have creditable coverage, you will owe a penalty. You will need to contact Medicare to see where you fall.
-Amy from https://www.senior65.com/


By D on March 12, 2017

I will be 65 in June. I'm covered right now bymy retirement insurance. Do I need to sign up for part B Medicare?

D,
You will need to contact your retiree insurance to see if you need to enroll in Part B. The reason is some will require that you enroll, and others will recommend that you delay your Part B.
-Amy from https://www.senior65.com/


By mike whitney on March 05, 2017

I will be retiring from the Florida Public School system this year. I am covered by my school group insurance during my retirement and, of course, by Medicare A. I also have substantial savings. Do I need Medicare B?

Mike,
You can delay Part B if your group insurance is considered creditable coverage. You will want to contact Medicare and your group provider to confirm this.
-Amy from https://www.senior65.com/


By Fred Jaramillo on October 09, 2016

I got a huge bill from Medicare. Huge to me anyway. It was totally unexpected. I've paid into Medicare all my working life, and am now retired. I am fully covered by my teacher retirement until I turn 70. I am also covered by wife, who still works for the same school district I retired from. In addition, she will have full health coverage until she is 75, and I will be covered under her up until that point. Do I need part B? Somehow I signed up for it without knowing I was doing so.

Fred,
You will want to contact your retiree insurance and your spouse's insurance to see if you need Part B. As well as, you will want to contact CMS to see if you will get a late penalty if you drop B and enroll later on. Hope this helps!
-Michelle from https://www.senior65.com/


By Ronald V. Ruehl on October 03, 2016

At age 65 I signed up for Part A and Part B Medicare coverage. I am a retired federal employee and have health insurance. I am being told that I do not need Part B since I have the government health insurance. If I decide to drop Part B at this time, is there any penalty for re-signing up for Part B at a later date. Thanks for any guidance you can provide.

Ronald,
You will want to contact CMS directly to find out if you will owe a penalty for dropping and resigning up for Part B. Best of luck!
-Chris from https://www.senior65.com/


By Marie-Thérèse Matthews on October 01, 2015

My husband is a 100% permanently disabled veteran since last May. His medical care is covered completely by the VA. Which part of Medicare can he safely cancel?

Marie-Therese,
Your husband can choose to cancel/delay Medicare Part B. He will only want to do this if he checks first with the VA to see how this would work for his health care, and if he does not plan on seeing any non-VA doctors or get any other non-VA services. Hope this helps.
-Michelle from https://www.senior65.com/


By Lee on May 18, 2015

Thank you for this. I never knew I could delay Part B. I'm going to talk to my HR person to see if my coverage qualifies and if it does I'm delaying.


By Liska on May 15, 2015

Do you think I should wait to get Part B? I go to the doctor once a year. It seems I could save money, even if I paid the penalty.

Liska,
Thank you for your question. We don't suggest anyone delay enrolling into Part B unless you have creditable coverage from work or another source. Although, we know what you're saying, you can't foresee future health issues. Hope this helps you.
-Chris from https://www.senior65.com/



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PLEASE NOTE: We cannot comment on specific Medicare claims. Contact Medicare directly if you are trying to see if your issue is covered.


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