Medicare Blog

when you might not want medicare part b

by Dr. Tillman Blanda II Published 2 years ago Updated 1 year ago
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You may not need Medicare Part B right away. If you’re over the age of 65 and don’t have any health problems, you may be able to wait until later to enroll in Medicare Part B. Medicare Part B is a program that helps pay for medical insurance. It’s like a Social Security plan, but it covers medical expenses not just retirement income.

Full Answer

Should you say no to Medicare Part B coverage?

You need to think twice about saying no to Medicare Part B coverage, even though it costs a monthly premium to use it. (If that amount would be a hardship, you may be able to have the premiums paid by your state.)

What is Medicare Part B and who needs it?

Medicare Part B helps qualified Americans pay health care costs related to doctor visits, lab testing, preventative services, and more, but this coverage isn't free, and not everyone needs it. Those who don’t need Part B can disenroll—but it’s not a straightforward process.

Can I delay enrolling in Medicare Part B?

An increasing number of Americans are putting off enrolling in Medicare Part B when they first qualify for it. Medicare-eligible individuals can delay enrolling in Part B only if they’re covered by an employer-sponsored group health plan (GHP) through a current job (their own or their spouse’s).

Should I Drop my Medicare Part B?

Feel free to drop your Part B coverage if you wish. The Part B premiums might not be worth any additional coverage you receive. But if you have secondary-payer insurance at work, it’s usually better to keep Part B, or you could get stuck paying Medicare’s share of your health care expenses.

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Can I refuse Part B Medicare?

You can decline Medicare Part B coverage if you can't get another program to pay for it and you don't want to pay for it yourself. The important thing to know about declining Part B coverage is that if you decline it and then decide that you want it later, you may have to pay a higher premium.

What happens when you cancel Medicare Part B?

The Part B late penalty is especially important to understand because it will stay with you the entire time that you have Medicare. The way the penalty works is that you pay a 10 percent increase for every 12-month period that you could have had Medicare coverage, but didn't.

Can you disenroll from Medicare Part B at any time?

You can voluntarily terminate your Medicare Part B (medical insurance). It is a serious decision. You must submit Form CMS-1763 (PDF, Download Adobe Reader) to the Social Security Administration (SSA). Visit or call the SSA (1-800-772-1213) to get this form.

How do I not pay for Medicare Part B?

Those premiums are a burden for many seniors, but here's how you can pay less for them.Sign up for Part B on time. ... Defer income to avoid a premium surcharge. ... Pay your premiums directly from your Social Security benefits. ... Get help from a Medicare Savings Program.

Should I cancel Medicare B?

Feel free to drop your Part B coverage if you wish. The Part B premiums might not be worth any additional coverage you receive. But if you have secondary-payer insurance at work, it's usually better to keep Part B, or you could get stuck paying Medicare's share of your health care expenses.

Can I opt out of Medicare?

If you do not want to use Medicare, you can opt out, but you may lose other benefits. People who decline Medicare coverage initially may have to pay a penalty if they decide to enroll in Medicare later.

How do I get $144 back from Medicare?

How do I qualify for the giveback?Are enrolled in Part A and Part B.Do not rely on government or other assistance for your Part B premium.Live in the zip code service area of a plan that offers this program.Enroll in an MA plan that provides a giveback benefit.

Is Medicare Part B automatically deducted from Social Security?

Yes. In fact, if you are signed up for both Social Security and Medicare Part B — the portion of Medicare that provides standard health insurance — the Social Security Administration will automatically deduct the premium from your monthly benefit.

Why is my first Medicare premium bill so high?

If you're late signing up for Original Medicare (Medicare Parts A and B) and/or Medicare Part D, you may owe late enrollment penalties. This amount is added to your Medicare Premium Bill and may be why your first Medicare bill was higher than you expected.

Understanding What Medicare Part B Offers

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Medicare Part B Enrollment Options and Penalties

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The Cost of Medicare Part B

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Medicare Part B Financial Assistance

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Medicare Part B Special Circumstances and Updates

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Benefits of Medicare Part B

Medicare Part B covers a variety of routine healthcare visits and treatments. If you can afford the premiums, then you may want to take advantage o...

What is Medicare Part B?

Medicare Part B covers most of the services people expect in a health plan – such as outpatient physician visits , mental health services, lab tests, and physical therapy. It’s important to sign up at the correct time for this part of Medicare – because simple enrollment mistakes can result in gaps in coverage and lifelong premium penalties.

What is the penalty for delaying enrollment in Medicare Part B?

Those who postpone enrollment – and aren’t covered by a GHP – will owe a 10 percent Part B late-enrollment penalty (LEP) for every year they delay signing up.

How long is the Medicare Part B enrollment period?

If you meet these criteria, you’ll receive an 8-month long special enrollment period (SEP) during which you can enroll in Part B without penalty. The Medicare Part B SEP begins the sooner of when: ...

What is EGWP in Medicare?

Additionally, many employers offer retiree benefits through Employer Group Waiver Plans (EGWPs) – a type of Medicare Advantage plan. You have to be enrolled in Medicare Parts A and B to receive retiree benefits through an EGWP.

Can Medicare beneficiaries buy individual market policies?

In fact, Medicare beneficiaries are not allowed to purchase individual market policies other than Medigap plans. Many Americans are enrolled in the individual market when they qualify for Medicare – and can keep their individual market plan after becoming Medicare eligible.

Do you have to pay for Medicare if you have an individual market plan?

But once you’re eligible for Medicare, an individual market plan may pay little or nothing toward your care. This is why it’s important to enroll in Medicare (and a Medigap or Medicare Advantage plan) when you’re first eligible for the benefit.

Do large companies have to enroll in Medicare?

Employees of large companies (i.e., usually one with more than 20 employees) do not have to enroll in Medicare. However, if they choose to sign up for Part A and B, Medicare will act as secondary coverage and pay for care after the GHP pays.

Why don't people enroll in Medicare Part B?

And some people choose not to enroll in Medicare Part B, because they don’t want to pay for medical coverage they feel they don’t need. There are a variety of reasons why you might hesitate to pay for medical insurance. Likewise, you may be concerned about how the new healthcare laws affect Medicare Part B coverage.

When does Medicare Part B start?

If you delay enrollment, then you have to wait until the next general enrollment period begins. For Medicare Part B, you have from January 1 through March 31 to enroll. Coverage doesn’t begin until July.

How to reduce Medicare premiums?

One such way is to enroll in a Medicare Savings Program. Run by individual states in conjunction with Medicare, Medicare Savings Plans help you pay for medical costs associated with deductibles, coinsurance and copayments, in some cases. There are four Medicare Savings Programs available, but only three of them relate to Medicare Part B. They are:

What happens if you miss your Medicare enrollment window?

What happens if you miss your initial enrollment window? If you delay Medicare Part B enrollment, then you’ll have to wait to enroll when the general enrollment period starts. In this example, your birthday is March 8. Because you missed your initial window, you’ll have to wait until January of the following year to enroll and July of the following year to start receiving coverage.

How much does Medicare pay if you make less than $500,000?

Individuals who earn more than $163,000 but less than $500,000 per year will pay $462.70 in Medicare Part B premiums per month. If you earn $500,000 per year or more, your Medicare Part B premium will be $491.60 per month. These amounts reflect individual incomes only.

How long do you have to be in Medicare to get Medicare Part B?

You have a seven-month initial period to enroll in Medicare Part B. The seven months include the three months prior to your 65th birthday, the month containing your 65th birthday and the three months that follow your birthday month. If you turn 65 on March 8, then you have from December 1 to June 30 to enroll in Medicare Part B.

How much is Medicare Part B in 2021?

That premium changes each year, usually increasing. In 2021, the Part B premium is $148.50 a month. You’ll also have an annual deductible of $203 in 2021 (an increase from the $198 deductible in 2020).

How much is the penalty for not enrolling in Part B?

For example, if you did not enroll in Part B when first eligible and delayed your enrollment for 14 months (and if no enrollment exception applied), your standard Part B premium amount – including your late enrollment penalty – would be $149.05 per month.

When is the open enrollment period for Medicare?

This enrollment period (also called the Open Enrollment Period for Medicare Advantage & Medicare prescription drug coverage) lasts from October 15 to December 7 every year.

What is Medicare Supplement Insurance?

If you have Medicare Part A and Part B, you might also consider a Medicare Supplement Insurance (also called Medigap) plan. Medigap plans can help cover some of the out-of-pocket costs that Medicare does not cover, such as deductibles, coinsurance and copayments.

What is Medicare Advantage Plan?

A Medicare Advantage (Medicare Part C) plan is an alternative to Part A and Part B (though you still need to enroll in Part B before you can enroll in a Medicare Advantage plan). Your Medicare Advantage plan carrier (a private insurance company) provides all of your Part A and Part B benefits, instead of the federal government.

What happens if you don't have creditable coverage?

If you do not have “creditable coverage” after you first become eligible for Medicare Part B, you incur a penalty that you will pay when you eventually do enroll in Part B . The late enrollment penalty fee amount is a 10 percent increase in your Part B premium (which is $135.50 per month for most people in 2019) for each 12-month period you could ...

Do retirees have to enroll in Medicare?

You may be automatically enrolled in Medicare Part A. Your retiree health plan (if you have one) may require you to enroll in Medicare. Whether or not this is the case, many health plans coordinate benefits with Medicare. Medicare is the usually the primary payer.

Is Medicare Part B optional?

Medicare Part B is optional. Whether or not you need Part B depends on your individual situation . You need to be aware that once you become eligible for Part B (generally when you turn 65), you will incur a late enrollment penalty for not signing up for Part B and decide you want it later, unless you meet one of the exceptions to ...

What happens if you opt out of Part B?

Be aware that if you opt out of Part B and then later decide to join, you will pay a Part B late penalty. You’ll also need to wait until the next General Enrollment Period to enroll, which means there could be a delay before your coverage becomes active. In my opinion, most Veterans should sign up for Part B.

How much is Part B insurance?

Most people delay Part B in this scenario. Your employer plan likely already provides good outpatient coverage. Part B costs at least $148.50/month for new enrollees in 2020.

How much does Medicare pay for outpatients?

Your healthcare providers will bill Medicare, and Part B will then pay 80% of your outpatient expenses after your small deductible. Medicare then sends the remainder of that bill to your Medigap plan to pay the other 20%. The same goes for Medicare Advantage plans.

What to do if Social Security says no?

If he or she tells you no, be sure you get a full explanation on why you are able to delay your. Get a second opinion if you are unsure, and never rely on Social Security to give you the right answer. We’ve seen too many people get wrong answers from inexperience government employees.

Do you need Part B before you can enroll in Medigap?

Conclusion. To recap the important points in this article, most people need Part B at some point. When you enroll will depend on what other coverage you currently have when you turn 65. Also, Part B is not a supplement. You need Part B before you can enroll in Medigap or a Medicare Advantage plan.

Can you use FEHB instead of Medicare?

Some people have 2 different coverages that they can choose independent of one another. Federal employees who can opt to use their FEHB instead of Medicare are one group . The most common situation though is with Veterans.

Is Boomer Benefits free?

Not sure if you need to enroll? Well that’s what we are here for. Reach out to one of our team of Medicare experts here at Boomer Benefits. Our service is free, and we’d be glad to help.

What happens if you drop Part B and keep Part A?

If you’re dropping Part B and keeping Part A, we’ll send you a new Medicare card showing you have only Part A coverage. Write down your Medicare Number in case you need to go to the hospital or get Part A-covered services until your new card arrives.

How to drop Part B?

To drop Part B (or Part A if you have to pay a premium for it), you usually need to send your request in writing and include your signature.

What services does Medicare cover?

Your costs for health care: You may have to pay all of the costs for services that Medicare covers, like hospital stays, doctors’ services, medical supplies, and preventive services.

What happens if you opt out of Part B?

But beware: if you opt out of Part B without having creditable coverage—that is, employer-sponsored health insurance from your current job that’s as good or better than Medicare—you could face late-enrollment penalties (LEPs) down the line.

What to do if you drop Part B?

If you’re dropping Part B because you can’t afford the premiums, remember that you could save money on your health care costs in other ways. Consider adding a Medicare Advantage or Medigap plan instead of dropping Part B. Call us to learn more about these alternatives to disenrolling in Part B.

What is primary payer health plan?

A primary payer health plan pays before Medicare. That means your employer-provided health plan will cover its share of your health care costs first, and if there’s anything left over that Medicare covers, Medicare will pay what remains.

How to schedule an interview with the SSA?

You can schedule an in-person or over-the-phone interview by contacting the SSA. If you prefer an in-person interview, use the Social Security Office Locator to find your nearest location. During your interview, fill out Form CMS 1763 as directed by the representative. If you’ve already received your Medicare card, you’ll need to return it during your in-person interview or mail it back after your phone interview.

Is Medicare a secondary payer?

Conversely, a secondary payer health plan covers only costs left over after Medicare covers its share. If your health plan at work is a primary payer, that’s great. Feel free to drop your Part B coverage if you wish. The Part B premiums might not be worth any additional coverage you receive. But if you have secondary-payer insurance ...

Can Medicare tack late enrollment penalties?

If you have a gap in coverage, the Medicare program could tack late-enroll ment penalties onto your Part B premiums if you re-enroll in coverage again later. Avoid this pitfall by working with your human resources department to ensure that your company's insurance is indeed creditable (meaning that it’s as good or better than Medicare Part B). You may need to provide documentation of creditable coverage during your Part B cancellation interview.

Does Medicare Advantage offer rebates?

Consider a Medicare Advantage plan that offers a rebate on your Part B premium. Here's how that works: A Medicare Advantage plan provides the same or better coverage than Part A (hospital insurance) and Part B (medical insurance). To receive this coverage, most enrollees pay a premium for their Medicare Advantage plan in addition to the cost ...

How can I make sure I’m not covered by Medicare by mistake?

Question: I plan to continue working past age 65 and continue receiving health care benefits from my employer. I plan to keep making contributions to my health savings account (HSA), and I understand I should not sign up for any Medicare coverage, including Part A.

What is the penalty for late enrollment in Medicare?

This penalty will tack on 10% to monthly Part B premiums (now $135.50 for most enrollees) for each full year you are late in enrolling.

Do you have to notify Medicare of your intention to get Medicare?

You do not need to notify Medicare of your intention not to get Medicare. In fact, Medicare doesn’t even handle Medicare enrollments. Social Security does this work. I urge people who turn 65 to pay careful attention to their Social Security mail, because the agency occasionally does mistakenly enroll people in Medicare.

Does it hurt to sign up for Medicare online?

It also doesn’t hurt to sign up for a personalized online My Medicare account. This account includes your Part A and Part B status, and thus will reflect any improper enrollments.

Do you have life insurance when you retire?

Phil Moeller: From your question, it appears that you have retained life-long health insurance coverage from your employer during your retirements. If so, congratulations!

Does considerable.com pay commissions?

The editors of Considerable.com determine the recommendations of products and services that appear in articles through rigorous reporting. If you buy a product from a retailer through a link on the site, Considerable.com may be paid a commission through our participation in an affiliate marketing program. These fees in no way affect our reporting or recommendations.

Is Medicare a conflict with HSA?

Phil Moeller: Your understanding of the HSA rules is correct. Having Medicare is a conflict with the tax-deductibility of HSAs.

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