Medicare Part B Is Your Medical Insurance

Some people get Part B automatically, and others will need to sign up.

Medicare Part B — medical insurance — helps pay for doctors services, ambulance services, outpatient care, durable medical equipment, home health care, and some preventative services.

Lacayo Group Insurance is here to educate and answer common questions about Medicare Part B.

Define Preventative Care?

Preventative services are health care to prevent illness, such as the flu, or detect it as early as possible. Treatment will likely work best during the early stages of an illness.

If you get the care from a provider who accepts assignment, you pay $0 for MOST preventative services.

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How Much Does Part B Cost?

You’ll pay a share of the costs for the services covered under Part B. Typically, you pay the yearly deductible ($203 in 2021). After you meet this deductible for the year, you generally pay 20% of the Medicare-approved amount for most doctor services, outpatient therapy, and durable medical equipment (DME).

Most people also pay the standard monthly premium (more on this below).

To find out if Medicare covers your item or service, you can talk to your doctor or explore your coverage online.

Should You Sign Up for Part B?

Part B is a little different than Part A. First, you must pay the standard premium amount for Part B coverage, which is $148.50 in 2021. This means you can actually turn down Part B.

However, if you decide not to enroll in Part B and then choose to do so later, your coverage may be delayed and you might have to pay a higher premium for as long as you have Part B. Your monthly premium will increase 10% for each 12-month period you were eligible for but did not sign up for Part B — unless you qualify for a Special Enrollment Period (SEP).

When to Sign Up

If you’re eligible for Medicare at age 65, your Initial Enrollment Period (IEP) starts three months before your 65th birthday, includes your birth month, and ends three months after your 65th birthday. If you don’t sign up during your IEP, you can enroll during a General Enrollment Period (GEP) from January 1 to March 31. Your coverage will begin on July 1 of the year that you sign up.

You May Qualify for a Special Enrollment Period

The exception to the above is if you have medical insurance under a group health plan — based on your or your spouse’s employment situation. In this case, you may not need to apply for Part B at 65.

You may be eligible for a Special Enrollment Period that will let you apply for Part B during:

Any month you stay covered under the group plan and you or your spouse’s employment continues.
The 8-month window that begins with the month after your group plan coverage or the employment ends — whichever comes first.

How to Apply

Have you lost employment or group health coverage? You can sign up for Medicare Part B online, over the phone, or in-person at your local Social Security office.

Consider Supplemental Insurance

Remember that Original Medicare doesn’t cover everything. If you already have Medicare, you can talk to an agent at Lacayo Group Insurance. We’ll go over your options for Medicare Advantage, Part D, and supplemental insurance (Medigap). Then, we’ll help you find the best plan for your situation and make sure you understand what it covers.

For more information on Medicare solutions in Florida, keep browsing our website or call us directly!

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