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Part B - The Medical Insurance Portion of Original Medicare

Medicare Part B beneficiaries receive coverage for medical expenses that are important for outpatient health care. Anyone eligible for Medicare Part A is qualified for Medicare Part B by enrolling and paying a standard monthly premium. Supposing a person is not eligible for Medicare Part A. In that case, a person can qualify for Medicare Part B when turning 65 if they are a U.S. citizen or a permanent resident residing in the U.S. for at least five continuous years.

Coverages Include:

  • Physician Services.
  • Outpatient Surgery.
  • Lab & X-ray Services.
  • Ambulance Services.
  • Some Preventive Services.
  • Durable Medical Equipment.

The Costs Associated With Part B:

  • Medicare Part B Monthly Premium – The Amount Changes Annually.
  • Annual Deductible – The Amount Changes Annually.
  • 20% Co-Insurance – The Covered Medical Expenses Medicare Does Not Pay.
  • Any Late Penalty’s Incurred From Not Obtaining Part B Coverage When First Eligible.

A Partial List of Services Not Covered By Medicare:

  • Preventative Care & Wellness Programs.
  • Routine Hearing Exams & Hearing Aids.
  • Routine Vision Exams & Corrective Lenses.
  • Comprehensive Dental Coverage.
  • Worldwide Emergency Assistance Outside The U.S.

Medicare Part B Enrollment:

Automatic enrollment in Part B Medicare insurance happens during the month of a person’s 65 birthday if they currently receive Social Security retirement benefits or Railroad Retirement Board benefits. If a person qualifies for Medicare insurance because of a disability before age 65, then enrollment is automatic for Medicare Part B when that person is considered Medicare eligible. Medicare Part B benefits start on the first day of the month during the month of turning 65. FYI – If a birthday falls on the first day of the month, the benefits will begin the first of the month, the month before turning 65.

If a person is not eligible for automatic enrollment and wants Medicare Part B when they turn 65, they must apply to get enrolled in Medicare Part B. If a person who is not eligible for automatic enrollment but wishes to continue with their employers’ group health plan, then they will qualify for a Special Election Period at their time of retirement. But, if a person does not enroll in Part B when they are first eligible for coverage and do not qualify for a Special Election Period from CMS. Then CMS will charge a lifetime late penalty to the monthly premium.

CMS Initial Enrollment Period – A Seven-Month Enrollment Timeline:

This Time Frame Includes:

  • Three Months Before The Month Of A 65th Birthday.
  • The Month Of A 65th Birthday.
  • Three Months Following The Month Of A 65th Birthday.

Ways To Enroll In Medicare Part B:

  • Create A My Social Security Account At: SSA.gov And Enroll Online.
  • Call Social Security: 800-772-1213, Monday-Friday, 7 am To 7 pm EST.
  • TTY Users Should Call 1-800-325-0778.

Assuming a person enrolls in Medicare Part B during the first three months of their Initial Enrollment Period, then benefits start on the first day of the month of turning 65. For people waiting to enroll in the month of their 65th birthday or the three months after their birthday. A significant coverage gap can and most likely will occur, depending on when the enrollment application is received and approved by CMS.