If you fail to enrol in Part B, certain 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? If you’re wondering the same, this article will help you make the right choice.

What Is Part B?

First things 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 choose to 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. You will be liable for the first 80% of all outpatient payments without it. Perhaps worse, when you are not fully participating in Part B as your primary coverage, your secondary coverage will not pay at all.

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. This means before you are even able to qualify for a Medicare supplement, you must be enrolled in Part B. Medicare will be billed by the healthcare providers, and Part B will then cover 80 percent of your prescription costs after your minimal deductible. Medicare also gives the Medigap account the balance of the bill to pay the other 20 percent.

Similar is the case with Medicare Advantage Plan, which doesn’t benefit you unless you enrol 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. By merely postponing your Part B registration until you retire, you can reduce the fee.

But, I’m a Veteran:

You can opt to bypass Medicare and get all of your services only at VA clinics and hospitals until enrolled 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.

Be mindful 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 enrol before the next General Enrollment Period, which means that there may be a delay before your plan becomes available.

Bottom Line

To summarize the important points, at some stage, most individuals need Part B. When you enrol, any other coverage you already have will depend on when you turn 65. Part B is also not a substitute. Before you can enrol 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 for Part B, you have to pay a premium, it offers a very substantial 80% of all your outpatient expenses.

Reach out Today at NewMedicare.