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Medicare Part B Premium and Benefits 2018

Under the Hold Harmless provision:

Part B enrollment special election rules

Before you sign up for your Part B Medicare coverage there are some Part B enrollment special election rules that you need to understand.

You are not required to take Medicare Part B during your Initial Enrollment Period (IEP)  (the first of the month you turn age 65) if you are have insurance through work and either you and/or your spouse is still working.  You should only delay Part B if the employer insurance (called group health insurance) is the primary payer on your health care expenses.  This means that Medicare would pay secondary (after your group/employer plan pays). It is a good idea to talk with the employer or the HR department to see which is the primary payer. Usually the employer must have more than 20 employees in their plan in order for the plan to be considered the primary insurance . If you are eligible for Medicare because you get Social Security Disability Insurance, the employer must have more than 100 employees to be the primary payer.

When there are fewer than 20 employees at the company where you get your insurance, Medicare is likely your primary coverage. If this is the case, you should not delay your part B enrollment. If you do so, that can leave you without any insurance coverage at all.

In either case:

If you have insurance from a current employer, you remain eligible for a Special Enrollment Period (SEP). During this time, you can enroll in Part B without penalty at any time. This is true while you or your spouse is still working.  This is also true for up to eight months after you lose employer coverage, switch to retiree coverage, or stop working. However, if you have a lapse in coverage more than eight months at any time after you become 65 and Medicare-eligible, you will lose your SEP. A lapse means any period of time where you were not covered by either Part B or insurance from a current employer.

Part B enrollment special election rules- Cobra and retiree insurance

Important: Medicare DOES NOT consider COBRA or any retiree insurance the same as current employer insurance. If you are on either of these, you will not have a Special Enrollment Period to enroll in Medicare beyond the eight months you have after you retired/stopped working. If you have COBRA or retiree insurance and delay enrollment in Part B, you will likely have a Medicare Part B late enrollment penalty when you do sign up for part B

It important to note:

If you had already taken Social Security before you turned 65, or if you become eligible for Medicare due to disability, you will be automatically enrolled in both Medicare Part A and Part B. It is not mandatory that you take Part B.  If you decide not to take Part B, you will need to send back the Medicare card you received in the mail with the form you received stating that you do not want Part B. After you do this, you will receive a new Medicare card in the mail. The new card will have part A only on it and not part B.  You will not need to pay your Medicare Part B premium as a result.

If you are thinking about turning down Part B—or enrolling in only Part A it is advised you call the Social Security Administration at 800-772-1213 and ask if you delay enrollment will you be subject to the Medicare Part B late enrollment penalty.   Be sure to explain the type and source of your other insurance and other circumstances in as much detail as possible. When you call Social Security, make sure to write down whom you spoke to, when you spoke to them, and what they said. Remember you generally must be covered under a group health insurance plan which you have access to due to you or your spouse working in order to avoid the part B late enrollment penalty.

Medicare Part B Coverage

Medicare Part B coverage is medical insurance.  Part B covers doctor visits.  It also covers well visits.  Coverage for medically necessary services and supplies is provided. This coverage includes any service or supply that you require for either diagnosis and or treatment of a medical condition. Part B also covers outpatient services.  Covered services include those provided by either a hospital, doctor’s office, clinic or other health care facility.

Medicare Part B also covers many preventive services to prevent illness or detect them at an early stage.  Together,  Parts A and Part B are known as Original Medicare.

Medicare Part B benefits

Medical services and supplies covered by Medicare Part B include (but may not be limited to):

• Doctor’s visits,
• Urgent care visits,
• Laboratory tests,
• X-rays,
• Emergency ambulance services,
• Mental health services, and
• Durable medical equipment.
• Preventive services, such as pap tests, flu shots, and screenings.
• Rehabilitative services, including physical therapy, occupational therapy, as well as speech-language pathology services.

Part B has a monthly premium associated with it.  The monthly premium is $104.90 in 2016.  If you get either Social Security, Railroad Retirement Board, or Office of Personnel Management benefits, your Part B premium will be automatically deducted from your benefit payment. If you don’t get these benefit payments, you’ll get a bill.   Note:   If you did no take Part B when you were first eligible, the cost of Part B will go up 10% for each full 12-month period that you  could have had Part B but didn’t sign up for it, except in special cases. You will have to pay this penalty as long as you have Part B.

Click here to learn how and when to enroll in Medicare.

Are you ready to sign up for Medicare?  You can sign up online.  Click here to enroll.

We are one of  the Northeast’s leading Medicare expert brokerages.  We do not charge consultation fees.  Feel free to contact the office at 203-796-5403 if you have questions.

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Medicare Part B Premium Costs

When turning 65, individuals need to understand the Medicare Part B Premium costs.

Individual Medicare recipients pay a premium each month for Part B. If you receive either Social Security, Railroad Retirement Board, or Office of Personnel Management benefits, your Part B premium is automatically deducted from your benefit payment.  If you do not get these benefit payments, you will receive a bill and can submit your payment from there.

Most people will pay the standard premium amount. However, if your modified adjusted gross income is above a certain amount, you may have to pay an adjustment.  In fact, this amount is determined by what is on your IRS tax return from 2 years ago.  This fee is called an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge that Medicare adds to your premium.

Click here for the Medicare.gov income requirements and information.

Click here to request a no obligation Medicare quote.

If you have questions regarding Medicare Part B costs or are ready to investigate plan options, please either call the office at 203-796-5403 or email us at admin@croweandassociates.com.  We are Medicare specialists and will be happy to help you navigate the both the options and process.

Who Should Enroll in Medicare Part B?

Deciding when and if you should enroll in Medicare Part B can be a daunting task.  Getting or maintaining the best coverage depends on your understanding of Medicare enrollment requirements as well as your current situation.

If you or your spouse are still working and receiving employer or union coverage, maintaining that coverage may be the best option.  You have 8 months to sign up for Part B without a penalty.  If you or your spouse (or family member if you’re disabled) are still working and you have insurance through that employer or union, contact your employer or union benefits administrator to find out how your insurance works with Medicare.

Your military or veteran status also plays a role in deciding the right coverage for you.

Click here to visit the Medicare.gov site to learn details.

Click here for a short video to help you understand some of the deciding factors regarding when to enroll.

If you are ready to enroll in Medicare Part B, need more information or have questions, please call the office at 203-796-5403 or email admin@croweandassociates.com for an appointment.  We are Medicare specialists and will be happy to help you navigate the process.

Click here for a free personalized Medicare quote.

Medicare A and B Benefits

Medicare A and B Benefits become available to most people when they turn 65.   Other people become eligible due to a state disability after 2 years.   Most people are automatically enrolled in Part A and pay no premium for it.  In fact, the majority of people (if they are drawing social security payments) are enrolled in part B.  In most cases, there is a cost of 104.90 a month for each person who is enrolled.  Some people pay more for part B, this amount is based on their income.  In some instances if you qualify for assistance, there will be a lower cost to no cost for Part B coverage.  This is also based on your income level.    You must apply through your state for this assistance in order to qualify for it. Read more

 Medicare Part B Late Enrollment Penalty

Individuals who are eligible and choose not to enroll in Medicare Part B will receive a Late Enrollment Penalty.   Medicare will assess this penalty for those people that do not enroll when first eligible.  Medicare Part B provides coverage for outpatient services.  These services include doctors visits, testing, scans, outpatient surgeries as well as anything else medical done outside of the hospital. Enrollment in Part B for most people is automatic when they turn 65. Individuals usually pay $104.90 a month for part B benefits.  This amount can vary according to your income.

There is a penalty for not enrolling in part B when first eligible to do so.  The current penalty is 10% of the premium for every year that you choose not to elect Part B coverage.   You need to have Medicare A and B in order to purchase a Medicare supplement or Medicare Advantage plan.  What if you have coverage through your employer?  For those age 65 and over actively working and being provided with coverage from an employer it may not make sense to buy part B. Read more

Should You Buy Medicare Part B

Medicare Part B becomes available to people when they turn 65.  Unless, they are eligible prior to 65 due to permanent disability. If you are turning 65 in the near future, you may ask yourself; Should You Buy Medicare Part B.   Part B of Original Medicare covers outpatient services.  These services include doctors visits, lab work, testing, outpatient surgery and most medical procedures done on an outpatient basis.  In general Medicare Part B covers 80% of the cost of services after you meet the annual deductible.

There is a cost for Medicare Part B

There is a standard Part B cost for most people, although it can be higher for those earning higher income. There is also a penalty for those that do not purchase Medicare Part B when they are first eligible for it.  Most people will pay the penalty if they enroll late.  There will not be a penalty for someone 65 or older if they receive coverage from their employer and are actively working.  The penalty also would not apply to the spouse on the plan.  If someone is 65 or older and getting coverage from an employer but is NOT actively working, they will pay a penalty for not signing up for part B when first eligible.

As a result, it is advisable to purchase Part B when first eligible.  Unless you fall under the actively working and getting coverage category.  You cannot purchase a Medicare Supplement or Advantage plan without Part B of Medicare.  This is another good reason to purchase it when you are eligible.

If you would like more information about health insurance plans. Please contact us either by phone at (203)796-5403 of by email at admin@croweandassociates.com.  We are here to help you feel comfortable with your insurance coverage.   We will find  you a plan that fits both your medical needs and your budget.

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When someone first becomes eligible for Medicare, they have the choice to sign up for part B.  Part B of Medicare covers physician and outpatient services at 80% after a $144 deductible.   Part B doe have a cost which is $104.90 a month. (deducted out of your social security check or billed quarterly)

Should everyone sign up for part B?  The answer is no.  Anyone that 65 or older and actively working may get stronger coverage from their employer.  If they are actively at work, they do not need to sign up for part B.   They can wait until they retire and sign up then. There will not be a penalty because they are actively at work. (same goes for someone getting benefits from an actively working spouse)

If you are getting benefits but not actively at work, you will be accumulating a penalty for not taking part B when you are eligible for it. The penalty is 10% of the premium for every year you are eligible but do not elect part B.    This may be a problem if you ever lose your retiree coverage and need to sign up for B down the road.

The original Medicare A and B benefits are updated every January.  The benefits do not change drastically from year to year but they usually increase slightly . The changes are made areas such as the Medicare Part A Inpatient Hospital Deductible, daily skilled nursing home copy, annual Medicare part B deductible, etc….. Read more