Maybe you're not quite sure when to enroll in Part B, or you're unfamiliar with the coverage and costs involved in Medicare's outpatient insurance. If so, this video is a must-watch as we're unboxing everything you need to know about Medicare Part B.
You'll use your Part B at doctors' offices, as it's your outpatient coverage. Part B covers medically necessary services given by a provider. This includes preventive care, surgeries, and other treatments.
Some medically necessary services Part B will cover include mammograms, colonoscopies, lab testing, durable medical equipment, occupational therapy, transplants, home health services, medications administered at the doctor's office, outpatient mental health services, ambulance services, vaccines (such as for the flu or Hepatitis B), and some services you receive in the hospital.
Moving on to Medicare costs, Part B comes with a monthly premium. Each year, there is a standard premium amount that is adjusted if your income is higher. Each year, the Part B premium is subject to increase and the standard amount is announced each year in the late fall, as is the annual deductible for Part B.
In addition to the premium and deductible, Part B also involves coinsurance. Medicare pays 80% of the approved amount, leaving the beneficiary responsible for the remaining 20%. This means you'll need to pay 20% for all services received at the doctor's office.
Unfortunately, Part A and Part B don't have out-of-pocket maximums. So, the 20% you pay out-of-pocket can quickly add up. Luckily, this is where Medicare Supplement (Medigap) plans can help. They cover the 20% coinsurance, thus protecting you.
Last but not least, we're going to let you know when to enroll in Part B. The first enrollment window every Medicare beneficiary has to enroll in Part B is the initial enrollment period. It's unique to you and starts three months before your 65th birthday, ending three months after your 65th birthday. Thus, you have seven months to enroll in Part A and Part B. Keep in mind that if you don't enroll during the first three months of this period, your coverage could be delayed and won't become active until after you turn 65.
If you're collecting Social Security benefits, you'll automatically enroll in Original Medicare (Parts A and B), and your Part B premium will be deducted from your Social Security check each month. If you're not collecting Social Security, you'll have to enroll yourself. If you have another form of creditable coverage, like group medical insurance through a large employer, you can delay enrollment in Part B and avoid penalties.
Once you leave your employee group coverage when you retire, you'll get a Special Enrollment Period of eight months. Make sure to get the right documentation for proof of coverage.
Those who miss their Initial Enrollment Period and don't qualify for a Special Enrollment Period can use the General Enrollment Period to sign up for Part B. This enrollment period occurs annually, from January 1 through March 31. If you sign up during this time, your coverage will begin on July 1.
When you lack creditable coverage at the time of enrollment, you'll face a penalty of 10% for every 12 months you went without coverage. Unfortunately, this penalty will stick with you forever. This is why it's so important to be familiar with what constitutes creditable coverage and why you shouldn't just assume you don't need Part B yet.
If you're new to Medicare, and you're not quite sure when to roll the Part B, or if you already have Part B, but you're not quite sure what it covers, or how much it cost. Don't go anywhere. In today's video we're going to unbox everything you need to know about Medicare Part B. Hi Medicare Community. My name is Lindsey Malzone and im the Medicare expert for Elite Insurance Partners and MedicareFAQ.com. Many Medicare beneficiaries are aware that they need to have Part B but they're not quite sure when to enroll, what it covers, or what it cost. First, let's go over what Medicare Part B covers. Medicare Part B is your outpatient coverage or also known as your doctor's coverage. Basically, Medicare Part B covers any medically necessary Services given by a provider. Medicare Part B will cover your preventive care, surgeries, and treatments. For example, Medicare Part B will cover mammograms, colonoscopies, lab testing, durable medical equipment, occupational therapy, transplants, home health services, medications that are given at the doctor's office, outpatient mental health services, ambulance services, vaccines like the flu or Hepatitis B, as well as some services that you might receive in the hospital. Next, let's go over what Medicare Part B costs. Unlike Part A, Part B comes with a monthly premium. There's a standard premium as well as an adjusted amount if you are higher income earner. This is known as IRMAA. That stands for Income-Related Monthly Adjustment Amount. The monthly premium you pay for Part B does 99% of the time, increase annually. The following years monthly premium is announced usually towards the end of October or beginning of November. Part B also comes with an annual deductible. This is also 99% of the time increased annually. It is announced along with the Part B monthly premium. In addition to the Part B premium and deductibles, it also comes with coinsurance. Medicare will pay 80% of the Medicare approved amount. Leaving you responsible for the remaining 20%. This means you'll have to pay 20% of all services received while at the doctor's office. Unfortunately, with Part A and Part B, there is no out-of-pocket maximum. Since there's no maximum out-of-pocket limit, that 20% can quickly add up. That's where a Medicare Supplement Plan comes into play. It will cover that 20% coinsurance protecting you from significantly high out-of-pocket cost. Last but not least, we're going to go over when to enroll in Part B. The first enrollment window every Medicare beneficiary has to enroll in Part B is during your Initial Enrollment Period. Your Initial Enrollment Period will begin 3 months before your 65th birthday, run through the month of, and end 3 months after your 65th birthday. This will give you a full 7 month window to enroll in Part B. Now, it's important to note, if you don't enroll the 3 months prior to your 65th birthday, your coverage could be delayed and won't become active until after your 65th birthday. If you're collecting Social Security benefits, you'll automatically be enrolled in Part B. The monthly premium for Part B will be deducted from your Social Security check each month. If you're not collecting Social Security, you'll have to enroll yourself. Now, not everyone needs to enroll in Part B when they're first eligible for Medicare. You may have another form of creditable coverage such as group employer insurance offered through your employer that has more than 20 employees. If this is the case, you can delay enrolling into Part B and you won't be penalized for it. Once you leave your group employer coverage and retire, you'll be given an 8-month Special Enrollment Period to enroll in Part B. Make sure to get the right documentation from your employer that youll need to submit to Medicare to show proof of coverage. If you happen to miss your Initial Enrollment Period and you don't qualify for a Special Enrollment Period, the next window of opportunity you have to enroll in Part B is during the General Enrollment Period. The General Enrollment Period occurs annually between January 1st, and March 31st. If you enroll during this time, your coverage will begin July 1st. Once you're first eligible for Part B, if you delay enrollment without creditable coverage, you will be penalized. The penalty is a 10% increase in your monthly premium per 12 month period you went without coverage. What this means is if you delay enrolling into Part B for let's say three years, just because you didn't think you needed at that time. When you do enroll at 68, you're going to pay a 30% increase in the monthly premium then you would have paid if you enrolled when you are first eligible. Unfortunately, this penalty will stick with you forever. This is why it's so important to know what's considered creditable coverage under Medicare and to not delay enrollment just because you don't feel you need the coverage at that moment. Thank you so much for watching. I hope you found this video helpful. If you haven't already subscribe to our YouTube channel, make sure to do so. Notifications must be turned on so you're notified each time we upload a new video. We also have a great Medicare community on Facebook. There will be a link in the description below so you can join today. Until next time. Bye.