How Important Is Medicare Part B, And Do I Need It?

Question: Do I need Medicare Part B? Everyone gives me a different answer.

Answer: I answered a similar question a few weeks ago, but this is good to review it, as we have one week left of the general enrollment period for Medicare Part B.

This year there are two different enrollment periods from Jan. 1 to March 31. The brand new one is the Medicare Advantage Open Enrollment Period. This allows you to switch from any Medicare Advantage Plan to anything else you want.

The second enrollment period happening at the same time Jan. 1 to March 31 is the general enrollment Period for Medicare Part B. This is the time when those individuals who did not enroll into Medicare Part B when they were supposed to, are allowed to enroll into Medicare Part B.

There are legitimate reasons to not enroll in Medicare Part B when you are first eligible. Those reasons are: You are currently working and have Health Insurance from an employer group of 20 or more employees; You are covered by your spouse’s insurance and your spouse is currently working at an employer group of 20 or more employees. For individuals who have Medicare due to a disability the employer group must be 100 employees or more.

For all others who become eligible for Medicare, you should enroll in Medicare A & B. Sometimes that is missed. For these individuals, the only time they can enroll in Medicare Part B is during the general enrollment period, now. When an individual enrolls in Medicare during the general enrollment period, his coverage does not begin until July 1 of that year. he also may have a penalty for that late enrollment. The Medicare Part B penalty is 10 percent for each 12 months that you did not have Medicare. The 10 percent is calculated using the current Medicare Part B premium ($135.50). The late enrollment penalty is paid on top of the current Medicare Part B premium for the rest of your life, for most people.

I sometimes run into people who have not signed up for Medicare Part B because they have coverage ‘already.’ But if they are not getting that coverage from a current employment situation they must have Part B. I have three situations that are common for people not enrolling and in these situations, you will have a late enrollment penalty with Medicare Part B, if and when you decide to enroll in Medicare Part B.

¯ An individual has retiree coverage that is being paid for by their previous employer or through benefit time they have accrued.

¯ An individual has VA coverage, Champ VA, or Tricare and use that for your primary medical needs.

¯ An individual is a federal retiree or retired postal worker and they have insurance through the federal system.

In all three cases as well as others I didn’t list, if and when you decide to decline Medicare Part B after you have already turned 65, you will have a restricted opportunity to enroll in Medicare Part B from Jan. 1 to March 31 and you will have a late enrollment penalty.

Centers for Medicare & Medicaid Services (CMS) may have sent you a letter to remind you to sign up for Medicare Part B if you have not already. Those letters are issued to everyone who does not have Medicare Part B and some of you are allowed to wait to sign up. As I already mentioned, you may have legitimate reasons to delay signing up for Medicare Part B.

If you don’t have a legitimate reason to delay enrolling in Medicare Part B, this GEP is your opportunity to now sign up for Medicare Part B, between Jan. and March 31. The forms to begin Medicare Part B are obtained from the Social Security Administration (SSA). Once completed and turned in by March 31st, you will receive your Medicare Part B benefit beginning July 1. That is a significant delay in getting the coverage I believe you need. But if you don’t use this period this year, you will have to wait to the GEP next year and then wait until July 1 of that year.

I encourage individuals to enroll in Medicare Part B, even if they are Veterans or Federal retirees because those penalties can add up fast, making Medicare more and more expensive every year.

The general enrollment period rolls around every year. Time is running short, we only have a few days left to use this opportunity to get Medicare Part B. If you still don’t understand, please reach out and ask us. We love talking about Medicare.

To contact Janell Sluga, GCMC with questions or concerns, please call 720-9797 or e-mail janells@lutheran-jamestown.org.

COMMENTS