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Medicare Part B Coverage

Medicare Part B Coverage

Do I Have to Take Part B Coverage?

You don't have to take Part B coverage if you don't want it, and your FEHB plan can't require you to take it. There are some advantages to enrolling in Part B:

  • You must be enrolled in Parts A and B to join a Medicare Advantage plan.
  • You have the advantage of coordination of benefits (described later) between Medicare and your FEHB plan, reducing your out-of-pocket costs.
  • Your FEHB plan may waive its copayments, coinsurance, and deductibles for Part B services.
  • Some services covered under Part B might not be covered or only partially covered by your plan, such as orthopedic and prosthetic devices, durable medical equipment, home health care, and medical supplies (check your plan brochure for details).
  • You may go outside of the plan's network for Part B services and receive reimbursement by Medicare (only when Medicare is the primary payer) If you are enrolled in an FEHB HMO.
How Much Does Part B Coverage Cost?
The premium for Part B coverage is determined by Medicare. The monthly premium amount is available in the "Medicare & You" handbook produced by the U.S. Centers for Medicare and Medicaid (CMS) and is also available on the Medicare website at Before 2006, the Government generally funded about 75 percent of the total Part B premium. Starting in 2007, higher income beneficiaries began to receive a reduced subsidy which will be fully phased in by 2009. At that time, subsidies for higher income beneficiaries will range from about 65 percent to 20 percent of the total premium. This change will affect only about four percent of all Medicare beneficiaries. The Part B premium for 2009 ranges from $96.40 to $308.30, but will be adjusted annually.
What Happens If I Don't Take Part B as Soon as I'm Eligible?
If you do not enroll in Medicare Part B during your initial enrollment period, you must wait for the general enrollment period (January 1- March 31 of each year) to enroll, and Part B coverage will begin the following July 1 of that year. If you wait 12 months or more, after first becoming eligible, your Part B premium will go up 10 percent for each 12 months that you could have had Part B but didn't take it. You will pay the extra 10 percent for as long as you have Part B.

If you didn't take Part B at age 65 because you were covered under FEHB as an active employee (or you were covered under your spouse's group health insurance plan and he/she was an active employee), you may sign up for Part B (generally without an increased premium) within 8 months from the time you or your spouse stop working or are no longer covered by the group plan. You also can sign up at any time while you are covered by the group plan.

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