Medicare Part B, Or Not Part B

I talk to lots of people about Medicare.  One gentleman told me about his $1,258.80 mistake.  He signed up for Social Security and Medicare at sixty-five because he thought he had to.  Started receiving Social Security.  Got his Medicare Part A and Part B card.  Started paying his $104.90 for Part B.  At the end of the year, Jim sat down with him HR person to go over his health benefits.  Jim planned to work until 68 because his wife didn’t work and was on his health insurance.  He saw that he was paying a small amount for his family’s health insurance compared to most group health plans and getting excellent coverage.  He asked his HR person what he needed Medicare for, especially since it was an additional expense of $1,258.80 per year.  She informed him that he probably didn’t since his employer plan covered everything and he is not required to have Medicare Part B, if he has other creditable coverage.  Jim was not happy, but the mistake he made is very common.

Medicare Part B, or not Part B.  That is the question.  People assume that they need to enroll in Medicare Part B because they are required to enroll in Medicare Part A at 65.  Many people don’t understand the differences, the reasons, and the rules.  Medicare Part A is for the hospital and don’t cost anything because it was paid for during your working years.  Part B is for doctor and outpatient procedures.  That does cost something—currently $104.90 per month.  You still have a 20% co-insurance with that, but if you have other coverage that Medicare would deem creditable, you can delay enrolling in Medicare Part B.  There will be no penalty.  You may delay to avoid paying the premium and because the coverage that you currently have through an employer group plan is the same or better than what Medicare would offer.  Or, you have a spouse that needs the employer group health coverage because that person is not eligible for Medicare yet.

The question is: what should you do?  Make a comparison.  Get the details of your employer group health plan: premium, deductible, co-pays, co-insurance, and maximum-out-of-pocket.  Once you have those numbers, then you will be able to make a side-by-side, apples-to-apples comparison between your group plan and your Medicare options.  It may make more sense to go in the direction of Medicare and a supplement or Medicare Advantage than staying on your employer plan, or not.  It all depends on a number of variables.  I help people determine the direction that best fits their needs easily and quickly.

To B or not to B, that is the question.  It requires a little homework and comparison so that you can make an informed decision that will get you the best coverage at the most reasonable cost.