Part B: Medical Insurance

What Is Part B?

Medicare Part B is medical insurance that helps cover medically necessary services^1. This can include physician services, durable medical equipment, diagnostic testing, and laboratory services.

Another great thing about Part B is that it also covers many preventive treatments.  Not only are you entitled to an annual flu shot, but you are also covered to receive^2: 

• Hearing and balance exams
• Mammograms
• Dialysis
• Pap tests or pelvic exams
• Mental health care
• Medical nutrition therapy
• Hospital services
• Occupational therapy
• Outpatient surgery service and supplies
• Limited prescription drugs
• Practitioner services
• Physical therapy
• Prosthetic devices
• Transplant service

Who Is Eligible for Part B?

As long as you are 65 years old and live in one of the 50 states (including Washington D.C.), you will be automatically enrolled in Medicare Part B.  You are eligible at age 65 if^3:

• You receive or are eligible to receive Social Security benefits; or
• You receive or are eligible to receive Railroad Retirement Board benefits; or
• Your spouse is eligible; or
• You or your spouse (living or deceased, including divorced spouses) worked long enough in a government job where Medicare taxes were paid; or
• You are the dependent parent of a fully insured deceased child.

What Does Part B Cost?

Anyone who is eligible for free Medicare hospital insurance (Part A) can enroll in Medicare medical insurance (Part B) by paying a monthly premium.  Some beneficiaries with higher incomes will pay a higher monthly Part B premium^3.  Due to the associated premium with Part B, it is made optional to you. 

If you don’t sign up for Part B when you are first eligible, you may be required to pay a late enrollment penalty^1.  “For each 12-month period you delay enrollment in Part B, you will have to pay an extra 10% of the Part B premium, unless you qualify for a Special Enrollment Period.  In most cases, you will have to pay that penalty every month for as long as you have Part B^4."

To exemplify how this penalty can have an effect on your monthly premium, we will use Dorothy as an example:

Dorothy’s Initial Enrollment Period ended on December 31, 2006.  She waited to sign up for Part B until the General Enrollment Period in March 2009.  Her Part B premium penalty is 20%.  Since Dorothy waited a total of 27 months, this included two full 12-month periods.

Don’t do what Dorothy did!

References

1. Medicare.gov.  Medicare Part B. 

2. Medicare Consumer Guide.  Medicare Part B.

3. Social Security Online. Electronic Booklet.

4. Centers for Medicare & Medicaid Services.  Understanding Medicare enrollment Periods.