Is Enrolling in Part B Important?

If you fail to enroll in Part B, specific unfortunate incidents might occur, and it’s astounding how often it occurs. Throughout the year, we get calls from at least a dozen clients who either misunderstood what they wanted to have (or were misinformed by Social Security in some instances). They have some big health issues now and are learning that they have no way to pay for their treatment. Is Enrolling in Part B Important? Discover essential insights with our Medicare Part B Guide. Learn how it shapes your healthcare journey, covering outpatient services, Medigap, and more for informed enrollment decisions.

What Is Part B?

First, enrollment in Part B means coverage of almost all the other medical services except your room or board in the hospital.

Part B covers the “outpatient” needs of our beneficiaries. Medicare becomes the only insurance after you retire and don’t have access to any health plans.

Many incidents that arise both in and out of the hospitals are covered in Part B. Part B offers 80% coverage for clinic appointments, laboratory, physiotherapy, surgery, chemotherapy, radiation, dialysis, and much more.

Is Part B of Medicare optional? Yes, because certain individuals who still work may postpone it until they retire. However, since Medicare is predominant, it is a vital component of the overall health plan.

Medicare Primary Services:

The following are some scenarios in which your Medicare will be primary;

  • When you are 65 or older in a sector of fewer than 20 workers and have employer benefits
  • If you are under 65 on due impairment from Medicare and work for an employer of fewer than 100 workers
  • Whether you have a former company’s retiree insurance
  • You must be enrolled in Part B by the eighth month of COBRA health coverage.
  • With TFL or CHAMPVA, when you reach 65

All of these situations cause you to be enrolled in Part B. Without it, you will be liable for the first 80% of all outpatient payments. Perhaps worse, when you do not fully participate in Part B as your primary coverage, your secondary coverage will not pay.

Eligibility for Supplement Services:

Medigap programs are not a replacement for Part B. They are charged secondary to Part B.

Part B works with your Medigap plan to give you total coverage. Before you can qualify for a Medicare supplement, you must be enrolled in Part B. Medicare will be billed by the healthcare providers. After your minimal deductible, Part B will cover 80 percent of your prescription costs. Medicare also gives the Medigap account the bill’s balance to pay the other 20 percent.

Similar is the case with Medicare Advantage Plan, which doesn’t benefit you unless you enroll in parts A and B.

What if I’m Already Insured?

You can delay enrollment for Part B until you’ve retired. Most companies cover healthcare services that can reduce your spending. 

For new enrollees in 2020, Part B currently costs $148.50/month. You can reduce the fee by postponing your Part B registration until you retire.

But I’m a Veteran:

You can bypass Medicare and get all your services only at VA clinics and hospitals until you enroll in VA coverage. But I do not suggest this. For years, the VA system has been the target of significantly negative press about long waiting times. 

Enrolling in Sections A and B of Medicare gives you a civilian option. Medicare will pay for their approved services, and Veterans Affairs will pay for their approved services or items.

Remember that you will incur a Part B late penalty if you opt out of Part B and then plan to enter. You will still need to wait to enroll before the next General Enrollment Period, so there may be a delay before your plan becomes available.

Bottom Line

To summarize the essential points, most individuals need Part B at some stage. When you enroll, any other coverage you already have will depend on when you turn 65. Part B is also not a substitute. Before you can enroll in Medigap or a Medicare Advantage plan, you need Part B. 

Lastly, Part B is not free unless you apply for a lower-income Medicare Savings program. While you have to pay a premium for Part B, it offers a very substantial 80% of all your outpatient expenses.

Reach out Today at NewMedicare.

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About Gregory Whitfield

For over a decade, my professional compass has been guided by a single mission: to demystify Medicare for Americans navigating this critical crossroads. My expertise is built on a foundation of rigorously analyzing and comparing plans, with a particular focus on helping individuals find the best Medicare Advantage plans that align with their healthcare needs and lifestyles. This deep, practical knowledge extends across key states, where I have developed specialized insight into local market variations—from the dense provider networks of Florida and California to the unique considerations for seniors in Arizona and Colorado. My writing translates complex coverage details, enrollment periods, and cost structures into clear, actionable guidance. I am committed to providing readers with the authoritative and up-to-date information necessary to make confident decisions about their Medicare coverage, whether they are in Alabama exploring supplemental options or in Delaware evaluating Part D plans. My work is dedicated to ensuring that you have a trusted resource in the often overwhelming landscape of Medicare choices.

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