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Medicare Part B

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Medicare Part B 

Unlock a world of medical coverage with Medicare Part B - from doctor visits to diagnostic tests, it's the key to maintaining your health and well-being.

What is Medicare Part B Insurance?

Medicare Part B is a component of Original Medicare and covers medically necessary outpatient services and supplies for treating an individual's health condition. This may include doctor visits, lab tests, diagnostic screenings, medical equipment, ambulance transportation, and other outpatient services.

How much does Medicare Part B Insurance cost?

The federal government set the 2024 Part B standard premium: $174.70 up to income $103.000 single or $206,000 married

2024 Medicare Part B Annual deductible is $240 for 2024. Additionally, you will be responsible for 20% of the cost of all outpatient services, including doctor visits on the original Medicare Fee for Service. Most Medicare beneficiaries choose to have the monthly Medicare Part B premium taken from your monthly benefit if you receive Social Security. If you do not receive social security, you can elect to be billed directly.

Medicare Part B Insurance FAQs

Can I delay enrolling in Medicare Part B?

Some people may get Medicare Part A "premium-free." Still, most people have to pay a monthly premium for Medicare Part B. Because Medicare Part B comes with a monthly premium, some people may choose not to sign up during their initial enrollment period if they are currently covered under an employer group plan (either their own or through their spouse's employer).

If you are still working, you should check with your health benefits administrator to see how your insurance would work with Medicare.

Suppose you delay enrollment in Medicare Part B because you already have current employer health coverage. You can sign up later during a Special Enrollment Period without paying a late penalty. You can enroll in Medicare Part B at any time you are still covered by a group plan based on current employment. After your employer's health coverage ends or your employment ends (whichever comes first), you have an eight-month special enrollment period to sign up for Part B without a late penalty.

Remember that retiree coverage and COBRA are not considered health coverage based on current employment and would not qualify you for a special enrollment period. If you have COBRA after your employer coverage ends, you should not wait until your COBRA coverage ends to sign up for Medicare Part B. Your eight-month Part B special enrollment period begins immediately after your current employment or group plan ends (whichever comes first). This is regardless of whether you get COBRA.

What services are not covered by Part B?

Part B doesn't cover some services. You'll need to pay for them out of pocket. Some examples of these include:
  • Routine physical examinations
  • cosmetic surgery
  • Dental care, including dentures
  • Vision care, including eyeglasses or contact lenses
  • Hearing aids
  • Alternative health services like acupuncture and massage
  • Long-term care
  • Most prescription drugs

When can I apply?

Enrollment Periods

Initial Enrollment Period (IEP)

  • The Initial Enrollment Period (IEP) is a seven-month window when someone can first enroll in Medicare. The IEP begins three months before the month someone turns 65, includes their birthday month, and ends three months after.

Annual Enrollment Period (AEP) Oct 15 to Dec 7

  • The Medicare Annual Enrollment Period (AEP) for 2024 is October 15–December 7. During this time, beneficiaries can make changes to their current Medicare plan coverage, which will take effect on January 1 of the following year.

Medicare Advantage Open Enrolment Period (MA-OEP) Jan 1 to March 31The Medicare Advantage Open Enrollment Period (MA OEP) is January 1–March 31 each year and allows current Medicare Advantage plan members to make changes to their plan. These changes can include:
Switching to another Medicare Advantage plan

  • Dropping your plan and returning to Original Medicare
  • Adding a Medicare Part D (prescription drug) plan
  • Confirming or changing your plan choice
  • Reviewing your plan benefits

Special Enrollment Period (SEP)You can make changes to your Medicare Advantage and Medicare drug coverage when certain events happen in your life, like if you move or you lose other coverage. These chances to make changes are called Special Enrollment Periods. The types of changes you can make and the timing depend on your life event.
Starting January 1, 2024, if you sign up for Part A and/or Part B because of an exceptional situation, you’ll have 2 months to join a Medicare Advantage Plan (with or without drug coverage) or a Medicare drug plan (Part D). Your coverage will start the first day of the month after the plan gets your request to join.

You change where you live

  • I moved to a new address that isn't in my plan's service area.
  • I moved to a new address that's still in my plan's service area, but I have new plan options in my new location.
  • I moved back to the U.S after living outside the country.I live in, or recently moved out of a facility (like a nursing home or rehabilitation hospital).
  • I was in jail or incarcerated and have been released.

You lose your current coverage

  • I'm no longer eligible for Medicaid.
  • I left coverage from my employer or union (including COBRA coverage).
  • I involuntarily lose other drug coverage that's as good as Medicare drug coverage (creditable coverage), or my other coverage changes and is no longer credible.
  • I had drug coverage through a Medicare Cost Plan and I left the plan.
  • I dropped my coverage in a Program of All-inclusive Care for the Elderly (PACE) plan.

You have a chance to get other coverage

  • I have a chance to join other coverage offered by my employer or union.
  • I have or am enrolling in other drug coverage as good as Medicare drug coverage (like TRICARE or VA coverage).
  • I enrolled in a Program of All-inclusive Care for the Elderly (PACE) plan.

Your plan changes its contract with Medicare

  • Medicare takes an official action (called a "sanction") because of a problem with the plan that I'm in.
  • I'm in a plan that the state recently took over because of financial issues.
  • Medicare ends (terminates) my plan's contract, or my plan ends its contract with Medicare.
  • My Medicare Advantage Plan, Medicare drug plan, or Medicare Cost Plans contract with Medicare isn't renewed.

Other special situations

  • I'm eligible for both Medicare and Medicaid, or I get Extra Help paying for Medicare drug coverage.
  • I found out that I won't be eligible for Extra Help next year.
  • I can't get premium-free Part A (Hospital Insurance) coverage, and I signed up for Medicare Part B (Medical Insurance) during the General Enrollment Period (January 1–March 31).
  • I qualify for Extra Help paying for Medicare prescription drug coverage.
  • I'm enrolled in a State Pharmaceutical Assistance Program (SPAP).
  • I'm enrolled in a State Pharmaceutical Assistance Program (SPAP) and I lost SPAP eligibility.
  • I dropped a Medigap policy the first time I joined a Medicare Advantage Plan and I'm still in a "trial period" and eligible for guaranteed issue of a Medigap policy.
  • I want to join a plan with a 5-star quality rating.
  • I'm in a plan that's had a star rating of less than 3 stars for the last 3 years.
  • I have a severe or disabling condition, and there's a Medicare Chronic Care Special Needs Plan (SNP) available that serves people with my qualifying condition.
  • I'm enrolled in a Special Needs Plan (SNP) and no longer have a condition that qualifies as a special need that the plan serves.
  • I joined a plan, or chose not to join a plan, due to an error by a federal employee.
  • I wasn't properly told that my other private drug coverage wasn't as good as Medicare drug coverage (creditable coverage).
  • I wasn't properly told that I was losing private drug coverage that was as good as Medicare drug coverage (creditable coverage).
  • Other exceptional circumstances

General Enrollment Period (GEP) Jan 1 to March 31 

  • The General Enrollment Period (GEP) for Medicare is January 1–March 31 each year. 
  • During this time, people who are eligible for Medicare Parts A and/or B but didn't enroll when they were first eligible can sign up. Coverage begins the month after enrollment
  • There may be penalties for signing up during the GEP. For example, if you don't enroll in Part B or premium Part A when you're first eligible, you might have to pay a late enrollment penalty. The penalty for Part A is 10% added to the premium for each year you delay enrollment. The penalty for Part B is also 10% added to the premium for each year you delay enrollment.

Already have Medicare Part B ? Switching is easy

It might be time to switch insurers whenever your existing insurer's service doesn't meet your needs. For example, it might be time to consider other options if you have poor claims experience or an unexplained rate increase.

If you cancel a previous policy before a new policy is effective, you could run into some serious financial problems.

Contact us today to help you with multiple options to choose from.
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Jeffrey Lange Insurance Agency

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