Note on refrigerator about enrollment for Medicare Part B

Your Medicare Part B enrollment can happen at different times. There are three enrollment periods when you can sign up for Medicare Part B. There are also situations when you can get enrolled in Part B automatically and don’t have to sign up yourself. We summarize the facts about Medicare Part B enrollment periods, cover the eligibility requirements, and outline another way you can get Medicare Part B coverage and extra benefits for services Part B doesn’t cover.

When Is Medicare Part B Open Enrollment?

You can sign up for Medicare Part B when you’re first eligible during your Initial Enrollment Period (IEP). If you don’t enroll during your IEP, you can get Part B during the General Enrollment Period (GEP), which occurs every year from January 1 to March 31. You also have Special Enrollment Periods (SEPs) when you can get Part B if you have a qualifying life event.

Medicare Part B Initial Enrollment Period

Your Initial Enrollment Period (IEP) gives you a seven-month window for Medicare Part B enrollment. Your IEP happens during:

  1. The three months before you turn 65, your 65th birthday month, and the three months after you turn 65.
  2. The three months before your 25th month of receiving disability benefits, your 25th month of getting disability benefits, and the three months after your 25th month of disability benefits.

Medicare Part B General Enrollment Period

You can sign up for Part B during the General Enrollment Period (GEP) from January 1 to March 31, if you didn’t do so during your IEP and you don’t qualify for a Special Enrollment Period (SEP). If you enroll in Medicare Part B benefits during the GEP, your coverage will begin July 1, and you may be subject to a late enrollment penalty for the entire time you have Part B, which means you could pay a higher premium.

Medicare Part B Special Enrollment Period

After your IEP ends, you have a Special Enrollment Period (SEP) to sign up for Medicare Part B if you, or your spouse, are still working or have group health coverage through a current employer. You also get an eight-month Medicare Part B Open Enrollment window starting the month after you or your spouse’s employment ends or your group health insurance through your current employer ends—whichever happens first. In most cases, you don’t pay the late enrollment penalty if you enroll in Part B during an SEP.

What Is Medicare Part B?

Medicare Part B is medical insurance that’s administered through the Medicare program. Medicare Part B, together with Part A hospital insurance, is known as Original Medicare. Part B covers medically necessary and certain preventive outpatient services, such as doctor’s visits, screenings to check for conditions such as cancer, lab tests, emergency room care, and ambulance services. Coverage for durable medical equipment such as wheelchairs, walkers, and oxygen equipment is also covered. Your Medicare Part B enrollment gives you access to these and other covered benefits.

Am I Eligible for Medicare Part B Enrollment?

Mature woman with questions about if she qualifies for Medicare Part BYour Medicare Part B eligibility depends on if you’re already getting, or are eligible for, benefits from Social Security or the Railroad Retirement Board (RRB) because:

  1. You’re 65 or older.
  2. You’re under 65 and have a disability.
  3. You have Amyotrophic Lateral Sclerosis (ALS), also called Lou Gehrig’s disease.
  4. You have end-stage renal disease (ESRD) and need regular dialysis treatment or have had a kidney transplant.

Do I Have to Sign Up for Medicare Part B?

Enrolling in Medicare Part B is voluntary. You may, however, be automatically enrolled if one of these three situations apply:

  1. You’re getting benefits from Social Security or the Railroad Retirement Board (RRB) at least four months before you turn 65. You’ll be enrolled in both Part A and Part B the first day of the month you turn 65.
  2. You receive disability benefits from Social Security or the RRB and are under 65. After your 24th month of getting disability benefits, you’ll be enrolled in Original Medicare (Parts A and B).
  3. You have ALS. Your automatic Part A and Part B coverage starts the month your disability benefits begin.

Note: If you live in Puerto Rico and meet the requirements above, you get Part A automatically. But if you want Part B, you have to sign up.

You’ll know you’ve been automatically enrolled if you get your Medicare card in the mail:

  • Three months before your 65th birthday.
  • The 25th month of receiving disability benefits if you’re under 65.
  • The first month your disability benefits begin if you have ALS.

If you’re not automatically enrolled, you would have to sign up during one of the Medicare Part B enrollment times mentioned above.

Medicare Part B Coverage When You Have ESRD

If you got solely Part A when you joined Medicare and later developed end-stage renal disease (ESRD), you can enroll in Part B if you’re eligible for an SEP or during the annual Medicare Part B Open Enrollment without having to pay the late-enrollment penalty. If you were already paying the Part B penalty and then were diagnosed with ESRD, the penalty will be removed from your Medicare Part B premium. These exceptions apply as long as you’re approved to enroll in Medicare Part B based on having ESRD.

An Alternative Way to Get Medicare Part B Benefits

Medicare Advantage, also known as Medicare Part C, provides an alternative way to get Original Medicare Part A and Part B benefits. One of the main advantages to getting Medicare Advantage is it includes extra health benefits for services that Original Medicare doesn’t cover. For example, you can get coverage for routine dental and vision care, hearing exams, and hearing aid fittings through a Medicare Advantage plan. Outpatient services such as these are not included in doctor’s visits covered under Part B. You can enroll in one of these plans, which are only available through private insurance companies that contract with Medicare, during your Initial Enrollment Period (IEP) or the Medicare Advantage Enrollment Period.

Get Help With Benefits Medicare Part B Doesn’t Cover

You have many choices to take advantage of health benefits that are not included with your Medicare Part B coverage. If you prefer to get Original Medicare Parts A and B, supplemental health, and prescription drug coverage under one plan, a licensed health insurance agent can compare Medicare Advantage plans in your area that work with your preferred doctors, specialists, hospitals, healthcare facilities, and pharmacies. Or, if you want to keep Original Medicare and add a separate plan for each benefit you want, we can help you with that, too. Our agents have access to plans such as senior dental, senior vision, long-term care, and individual Medicare Part D drug plans. We’re here to help you choose the best option when getting the additional benefits you want upon your Medicare Part B enrollment—all at no cost to you. Just give us a call at (800) 488-7621 or find a local agent to get help choosing coverage that fits your needs and budget.

 

This information is not a complete description of benefits. Limitations, copayments, and restrictions may apply. Benefits may change on January 1 of each year.

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References

https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-how-to-sign-up-for-part-a-and-part-b.html | https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-sign-up-parts-a-and-b/when-sign-up-parts-a-and-b.html | https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/when-can-i-join-a-health-or-drug-plan.html#collapse-3182 | https://www.medicare.gov/people-like-me/esrd/getting-medicare-with-esrd.html | https://www.medicare.gov/coverage/long-term-care.html

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