Medicare Part B is an important part of Original Medicare, covering many medical services such as; doctor visits, outpatient care, preventive services, and durable medical equipment. Individuals getting close to Medicare eligibility need to understand how to apply for Medicare Part B. Understanding the enrollment process can help avoid penalties and ensure healthcare coverage is not interrupted.
Who Needs to Enroll in Medicare Part B
Not everyone is automatically enrolled in Part B. Below is a list of the Individuals who need to self-enroll in Part B:
- Those who are not receiving either Social Security or Railroad Retirement Board (RRB) benefits at least 4 months before they turn 65.
- Anyone who delayed enrolment because they were enrolled in employer sponsored health coverage.
- Some disabled individuals that qualify for Medicare need to enroll in Part B.
When can you enroll
1. Initial Enrollment Period (IEP)
This is a seven-month window starting three months before the 65th birthday, including the birthday month, and ending three months after. For those who enroll early, coverage begins the first day of the birth month.
2. Special Enrollment Period (SEP)
Individuals may qualify for a SEP if they delayed Part B due to employer-sponsored coverage. They have eight months from the end of employment or loss of health plan to enroll without penalty.
3. General Enrollment Period (GEP)
Those who miss their IEP and don’t qualify for an SEP can enroll during the GEP. The GEP runs from January 1 to March 31, with coverage starting the first day of the month following the enrollment submission. When this is the case, a late enrollment penalty may apply.
Learn more about Medicare enrollment periods
How to enroll in Part B
Determine Your Enrollment Method
Those who are already receiving Social Security benefits will be automatically enrolled in Part B. When that is not the case, you must apply manually through SSA (Social Security Administration).
There are a few ways to apply for Part B
Online: Visit SSA.gov and complete the online application.
By Phone: Call the Social Security Administration at 1-800-772-1213 (TTY: 1-800-325-0778).
In-Person: Visit your local Social Security office (appointment recommended).
Step 3: Submit Form CMS-40B
If you’re enrolling due to a Special Enrollment Period, you must complete Form CMS-40B (Application for Enrollment in Medicare Part B) and possibly Form CMS-L564 (Request for Employment Information) to prove employer coverage.
Step 4: Wait for Confirmation
Once your application is processed, you’ll receive a Medicare card with your Part B coverage start date.
Delayed Part B
If you have employer coverage, you can opt out of Part B when first eligible. However, ensure that your employer plan qualifies for delayed enrollment without penalties.
Avoid Late Enrollment Penalties
For every 12-month period you delay enrollment without qualifying coverage, your Part B premium increases by 10%—for life. Enrolling on time prevents unnecessary costs.
Watch a YouTube video on OEP, SEPs & LEPs
Enrolling in Medicare Part B is a straightforward process, but timing is key to avoiding penalties and ensuring seamless healthcare access. If you’re unsure about your eligibility or enrollment timeline, consult the Social Security Administration or a Medicare advisor for guidance.
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