As you approach age 65, you’ll have to start making decisions about Medicare coverage. Most people will sign up for Original Medicare as soon as they become eligible, but before you do, it’s important to understand the difference between, and value of, the parts that make up Original Medicare.
Original Medicare consists of two parts. The first, Part A, covers inpatient hospital care, skilled nursing facility care, hospice care and some home health care. Part B, however, aims to provide coverage for medical services and supplies that are not covered under Part A, like preventive services and outpatient care.
If you already have Part A and are wondering whether to enroll in Part B, the decision will depend on various factors, like your current coverage, individual healthcare needs and budget. Let’s explore the benefits and costs associated with Medicare Part B so you can gain a better understanding of its value and make an informed decision about whether or not to enroll.
When is Medicare Part B necessary?
Medicare Part B coverage is optional, and whether or not it makes sense for you depends on your unique situation. If you still have employer-sponsored health insurance or other forms of coverage, it may not be necessary to enroll in Part B right away. However, if you don’t have coverage for specific healthcare needs, Part B can provide crucial access to necessary medical services. Medicare Part B coverage may be valuable if:
You’re 65 or older and enrolled in Medicaid
You have COBRA insurance (keep in mind that you must enroll in Part B by the 8th month of your COBRA coverage)
You’re 65 or older and have employer insurance coverage from an organization with 20 or less employees
You have Tricare for Life (TFL) or CHAMPVA and are turning 65
You’re under 65, work for an employer who has less than 100 employees and have Medicare Part A coverage due to disability
In these instances, Medicare Part B coverage can help you reduce your out-of-pocket expenses for outpatient care and certain medical supplies and preventive services.
Do you still need Medicare Part B if you’re already insured?
If your existing insurance already offers comprehensive coverage for outpatient services, you may not necessarily need to enroll in Medicare Part B immediately. However, it's crucial to carefully evaluate your current coverage to determine if any gaps or limitations exist. Some employer-sponsored health plans may have restrictions on certain services or may not cover all necessary medical expenses. In such cases, enrolling in Medicare Part B can provide you with additional coverage and access to a broader range of medical services.
Another factor to consider is Medicare costs. While Part A is generally premium-free for most individuals, Part B does come with a monthly premium. If your existing coverage is sufficient and you have no immediate need for the services covered under Part B, you may decide to delay enrollment to avoid paying unnecessary premiums.
Need help navigating Medicare Part B? SelectQuote can help.
Understanding Medicare Part B enrollment can feel confusing, so it’s important to have a team you trust on your side as you navigate coverage options. Let SelectQuote take care of the comparison for you so you can feel confident you have the coverage you need. Our licensed insurance agents will help you consider your unique situation, including your age, health status and employment to find the Medicare Advantage plan that works best for you.
