What Does Medicare Part B Cover
The following are some examples of what Medicare Part B covers:
- Ambulance services: transport and travel to and from certain locations
- Chemotherapy
- Chiropractic care for spine manipulation to correct a subluxation
- Diagnostic tests and lab work
- Doctors services, such as office visits
- Durable medical equipment
- Home health services
- Outpatient physical, speech, and occupational therapy services provided by a Medicare-certified physical, speech, or occupational therapist
- Outpatient mental health services, including partial hospitalization
- Preventive-care services, including screenings and vaccines
- Welcome to Medicare and yearly Wellness physical exams
- X-rays
If youre enrolled in a Medicare Advantage plan, youll still be covered for the same Medicare Part A and Part B coverage you would have had under Original Medicare. Medicare Advantage plans are required to provide at least the same level of coverage as Original Medicare, so youll have the same baseline level of benefits that you would have under the federal program. In addition, your Medicare Advantage plan may cover other benefits to keep you healthy, such as routine vision or dental, wellness programs, or prescriptions drugs.
Determine Whether You Need To Sign Up For Medicare
Some people are automatically enrolled in Medicare Part A hospital insurance and Medicare Part B medical insurance.
You are automatically enrolled in Medicare Part A and Part B if:
If you already collect Social Security retirement benefits, you are automatically enrolled in Medicare Part A and Part B. No further action is required.
Your coverage will begin the first day of the month you turn 65.
Even if you are automatically enrolled, you may also decide to:
- Sign up for a Medicare Part D drug plan.
- Buy a Medigap supplement insurance policy.
- Switch to a Medicare Advantage plan.
Signing Up For Original Medicare
There are a few different ways to sign up for Medicare Part A and Medicare Part B if you are not automatically enrolled.
Medicare Part A and Part B are also called Original Medicare.
3 Ways to Sign Up for Medicare Part A and Part B
If you worked at a railroad, call the Railroad Retirement Board at 1-877-772-5772 to sign up.
If you are not automatically enrolled, the best time to sign up for Medicare is during your initial enrollment period.
This is a seven-month window that begins three months before the first day of the month of your 65th birthday, includes your birth month and ends three months after your birthday.
Prepare for the Medicare Advantage Open Enrollment Period
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How To Enroll In Medicare Part A Only Or Medicare Parts A& b: A Step
Note from Suzanne:
Make sure you answer these questions correctly:Do you want Part B of Medicare? Answer YES Do you have group coverage? Answer NO
Once you have completed the online enrollment for Medicare, you will receive an E-mail confirmation that your application is being processed.
About 2-3 weeks after that you will receive your paper, red, white & blue Medicare card in the mail showing EITHER Medicare Part A only OR Medicare Parts A& B on it.
Give my office a call to let us know when you receive your Medicare card. Then we will be able to get your other insurance set up for you!
What Is The Medicare Part B Late
If you do not sign up for Medicare Part B when you are first eligible, you may need to pay a late enrollment penalty for as long as you have Medicare. Your monthly Part B premium could be 10% higher for every full 12-month period that you were eligible for Part B, but didnt take it. This higher premium could be in effect for as long as you are enrolled in Medicare. For those who are not automatically enrolled, there are various Medicare enrollment periods during which you can apply for Medicare. Be aware that, with certain exceptions, there are late-enrollment penalties for not signing up for Medicare when you are first eligible.
One exception is if you have health coverage through an employer health plan or through your spouses employer plan, you can delay Medicare Part B enrollment without paying a late-enrollment penalty. This health coverage must be based on current employment, meaning that COBRA or retiree benefits arent considered current employer health coverage.
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Sign Up For Medicare Part B Online
For many people, signing up for Medicare Part B doesnt require you to leave the comfort of home. Please visit our Medicare Part B webpage at if:
- Youre enrolled in Medicare Part A.
- You would like to enroll in Part B during the Special Enrollment Period.
You can complete form CMS-40B at www.cms.gov/Medicare/CMS-Forms/CMS-Forms/CMS-Forms-Items/CMS017339 and CMS-L564 at online.
You can also fax the CMS-40B and CMS-L564 to 1-833-914-2016 or return forms by mail to your local Social Security office. Please contact Social Security at 1-800-772-1213 if you have any questions.
Note: When completing the forms:
- State, I want Part B coverage to begin in the remarks section of the CMS-40B form or online application.
- If your employer is unable to complete Section B, please complete that portion as best you can on behalf of your employer without your employers signature.
- Submit one of the following types of secondary evidence by uploading it from a saved document on your computer:
- Income tax returns that show health insurance premiums paid.
- W-2s reflecting pre-tax medical contributions.
- Pay stubs that reflect health insurance premium deductions.
- Health insurance cards with a policy effective date.
- Explanations of benefits paid by the GHP or LGHP.
- Statements or receipts that reflect payment of health insurance premiums.
Please let your friends and loved ones know about this online, mail, or fax option.
When Is My Initial Enrollment Period For Medicare Part D
You can enroll in a stand-alone Medicare prescription drug plan during your Initial Enrollment Period for Part D. You are eligible for prescription drug coverage if:
- You live in a service area covered by the health plan, and
- You have Medicare Part A AND/OR Medicare Part B.
Generally, your Initial Enrollment Period for Part D will occur at the same time as your Initial Enrollment Period for Medicare Part B .
Once you are eligible for Medicare Part D, you must either enroll in a Medicare prescription drug plan, Medicare Advantage Prescription Drug plan, or have creditable prescription drug coverage . Some people may choose to delay Medicare Part D enrollment if they already have creditable prescription drug coverage through an employer group plan.
However, if you do not sign up for prescription drug coverage when you are first eligible for Part D, you may have to pay a late-enrollment penalty for signing up later if you go without creditable prescription drug coverage for 63 or more consecutive days.
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You Automatically Get Medicare
- You should already have Part A and Part B , because you have ALS and youre already getting disability benefits.
- We mailed you a welcome package with your Medicare card.
Sign up for Part B if you live in Puerto Rico or outside the U.S.
- Well mail you a welcome package with your Medicare card 3 months before your Medicare coverage starts.
Sign up for Part B if you live in Puerto Rico or outside the U.S.You get Part A automatically. If you want Part B, you need to sign up for it. If you dont sign up for Part B within 3 months after your Part A starts, you might have to wait to sign up and pay a monthly late enrollment penalty.
- Well mail you a welcome package with your Medicare card 3 months before your Medicare coverage starts.
Sign up for Part B if you live in Puerto Rico or outside the U.S.You get Part A automatically. If you want Part B, you need to sign up for it. If you dont sign up for Part B within 3 months of turning 65, you might have to wait to sign up and pay a monthly late enrollment penalty.
The Steps To Apply For Medicare Online If You Dont Have Part A And Part B
- The first step to apply online for Medicare is to go to ssa.gov or socialsecurity.gov Social security handles all the sign ups for Medicare, so dont worry that you are not enrolling in Medicare.
- Youll need to create a MySocialSecurity Account is you dont already have one. Just go to the top right and click Sign In/Sign Up. If you dont have an account already then just follow the steps to create a username and password.
- The next step is to apply for your Medicare. From the home page of ssa.gov, youll want to click on the box that says Medicare Enrollment. On the next page, scroll about three quarters of the way down and look for the Blue button that says Apply for Medicare Only. Here is where you can also come back and request a replacement Medicare card, check your application status, or return to a saved application if you havent finished it yet.
- This is where you can apply online for Retirement and/or Medicare benefits. Click on start a new application. Or you can return to a saved application. You will type in all the requested information about you.
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Medicare Annual Enrollment Period
Once you sign up for Original Medicare Part A and Part B, you are covered and dont need to renew it. But every year, during the Medicare Annual Enrollment Period you have an opportunity to change your Medicare health or prescription drug plan. This happens annually from Oct. 15 through Dec. 7. If you make a change during this enrollment period, your new plan benefits are effective Jan. 1 of the following year.
Read more info in our Medicare Annual Enrollment Period Guide.
The Best Time To Sign Up For Medicare Part B
U.S. seniors have a seven-month Initial Enrollment Period during which they can sign up for Medicare Part B or Part A. This period spans the time before and after your 65th birthday. It begins three months before your birthday month, includes your birthday month, and extends three months after.
If you dont sign up for Medicare Part B during your Initial Enrollment Period, you may face a late enrollment penalty.
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How Medicare Advantage Can Save You Money On Your Part B Premiums
If you don’t qualify for the above programs, you still have options. Consider a Medicare Advantage plan that offers a rebate on your Part B premium. Here’s how that works:
A Medicare Advantage plan provides the same or better coverage than Part A and Part B . To receive this coverage, most enrollees pay a premium for their Medicare Advantage plan in addition to the cost of Part B.
But in some areas, typically large cities, Medicare Advantage providers offer $0 plans to better compete with other insurance companies. A few go even further and offer enrollees a rebate on their Part B premiums. If you enroll in one of these plans, you could pay a lower monthly Part B premiumand have more benefits, such as prescription drug, dental, vision, and hearing coverage.
These plans aren’t available in all areas, but even the average Medicare Advantage plan could help save you money. With most plans, you won’t have to pay an extra premium for prescription drug coverage or dental insurance, for example, which could free up some cash to cover the Part B premium.
To find out if a Medicare Advantage plan could save you money, give us a call.
How To Enroll In Medicare If You Are Turning 65
When most people reach the age of 65, they are eligible to enroll in Medicare. Whether or whether they are getting retirement benefits when they enter their Initial Enrollment Period will affect how they enroll in Medicare .
- They will be automatically enrolled in both Medicare Part A and Medicare Part B if they are receiving Railroad Retirement payments or Social Security retirement benefits.
- They must actively enroll in Medicare if they are not receiving Railroad Retirement benefits or Social Security retirement benefits.
If they are automatically enrolled in Medicare, they should not contact anybody they will receive their Medicare card three months before their coverage begins.
They will also receive a letter explaining how Medicare works, and they will be informed that they do not need to enroll in Medicare because they were automatically enrolled and already have Medicare Parts A and B.
If they are eligible for Social Security retirement benefits, the Social Security Administration will send them a card and package . If they are eligible for Railroad Retirement benefits, the Railroad Retirement Board will send them a letter and package.
We advise them not to reject Medicare Part B unless they or their spouse have current work-based insurance .
If they do not have job-based insurance and refuse Medicare Part B, they may be charged a premium penalty if they need to enroll in Medicare later.
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How Do You Get Help With This Application
- Phone: Call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778.
- En español: Llame a SSA gratis al 1-800-772-1213 y oprima el 2 si desea el servicio en español y espere a que le atienda un agente.
- In person: Your local Social Security office. For an office near you check www.ssa.gov.
When Should You Apply For Medicare If You Have Employer Health Coverage
Most people should sign up for Medicare Part A when theyre first eligible because it rarely costs anything. But some people delay enrolling in Part B because they dont want to pay the monthly premium. The decision usually depends on the type of health coverage you already have.
You can put off enrolling in Part B at age 65 if you have group health coverage through your or your spouses job and the employer has at least 20 employees.6 Youll be able to enroll with no penalty during the Special Enrollment Period that follows the end of your employers insurance. You can also choose to enroll in Part B while still insured and pay the premium.
If your employer has fewer than 20 employees, you should apply for Part A and Part B as soon as youre eligible.7
Be sure to talk to your employers benefits administrator about how signing up for Medicare will affect your coverage or Health Savings Account .8 You cannot contribute to an HSA if you have Medicare Part A. Your administrator can help you time the beginning and end of your coverage through work and your new health insurance so theres no gap in your coverage.
When your group coverage is ending, youll need to complete documentation and submit it to your Social Security office. If you have questions, ask Social Security.
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Do You Need To Apply For Medicare
Most people do need to apply for Medicare. But if you reach age 65 and youre already receiving retirement benefits from Social Security or the Railroad Retirement Board, youll be signed up for Medicare Part A and Part B automatically.
And if you arent receiving retirement benefits and you dont have health coverage through an employer, you will need to apply for Medicare as you approach age 65. If you need to apply, Medicare gives you several options.
When Do I Sign Up For Medicare Advantage
Before you sign up for Medicare Advantage, make sure you weigh the pros and cons of Medicare Advantage vs. Medicare Supplements. If you choose to sign up for Medicare Advantage, you can do so during your IEP.
If you missed your IEP, you can join during the Medicare Annual Enrollment Period. For those currently enrolled in a Medicare Advantage plan, you also have another opportunity to make changes during the Medicare Advantage Open Enrollment Period.
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How Long Does It Take To Sign Up
That depends on the method you choose. It can take as little as 10 minutes to sign up online, a month or more by phone or, if you prefer to sign up in person, it will depend on how long it takes to get an appointment.
- Medicaid number, if applicable, with start and end dates.
- Start and end dates for group health insurance through your employer.
- Start and end dates of employment with the employer providing your group health plan.
Once your account is set up, you can start the Medicare application process here. Its unlikely that youll need to sign anything physically.
When youre finished applying online, youll get a confirmation number. Keep it handy and use it to check the status of your application through your My Social Security account. Social Security will let you know if more information is needed.4
How To Enroll In Medicare Online
To be clear, you dont have to sign up for Medicare online. You can do so over the phone or in person, but if youre looking to save time, completing an online application is probably the best way to go.
The first step in enrolling in Medicare online is creating an account on the Social Security Administrations web site. You do not need to sign up for Social Security at the same time as Medicare, so if thats not your plan, worry not. Youll be asked whether you wish to enroll in one program or both during the signup process.
Next, youll need to provide some basic information like your name, address, and telephone number, and youll also need your Social Security number to complete your application. In addition, youll need information that helps identify you, such as your birth certificate, drivers license, or proof of U.S. citizenship if you werent born in the U.S. If youre not a citizen, youll need your permanent resident card number.
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