Part B is an Original Medicare plan available to those who qualify at a low cost relative to many other senior insurance options. It provides general medical coverage, and is coupled with Part A for an overall beneficial and necessary plan.
Besides Part A, Part B makes up the other half of Original Medicare. One of the most common and widely regarded health insurance plans for seniors, Part B provides a lot of beneficial, necessary coverage to its recipients. This includes:
Generally speaking, however, Part B covers preventative services (anything used to detect or prevent future illnesses such as a flu shot), and most things that are deemed “medically necessary.” Medicare Part B does not cover certain costs, but you can easily find out what will be covered by speaking with your doctor or other healthcare provider.
Not everyone can purchase Part B. Here are the 3 basic eligibility requirements—you must meet at least one of these to qualify:
Once you have determined if you meet one of these qualifications, it is time to figure out when you should enroll. If you are under 65 with a disability, ESRD, or ALS, you can start your Part B plan using a Special Enrollment Period (SEP), meaning that you can enroll regardless of age.
Using a SEP also works if you are over age 65 but chose to delay your Medicare enrollment because you were still working. When you do officially retire, you can use the SEP and not have to worry about a Medicare Part B penalty.
What is a Part B penalty you may ask? It is a fee that incurs every year you do not sign up for Medicare when eligible. But, with a SEP, you do not have to worry about this. You can also avoid the penalty if you enroll when first eligible under the Initial Enrollment Period (IEP).
The IEP takes place during the 7 months surrounding your 65th birthday. You can enroll in Parts A and B during this time, as well as Medicare Advantage and Part D if you so choose.
If you miss the IEP and don’t qualify for a SEP, you can still enroll during the General Enrollment Period (GEP) which takes place January 1st through March 31st each year. You may have late fees when enrolling during the GEP, but it is still an excellent option if you missed your other opportunities but still want to enroll.
The cost of Medicare Part B is standard across the U.S. (though it may vary based on income). Your premium and deductible are liable to change each year based on federal and state laws. But, the 2023 Medicare Part B premium is $164.90, and the deductible is $226.
If your income is over a certain limit determined by the Income Related Monthly Adjustment Amount (IRMAA), your Medicare Part B premium will be higher than the average.
The $164.90 Part B premium is set based on income, though most people do not realize it. The IRMAA considers your tax filings from 2 years ago and uses it to categorize you into an income bracket. The higher your income, the higher the bracket, and thus a higher premium.
Medicare bases the IRMAA on your IRS records from two years ago. So, in 2023, it will use your 2021 report. This report is known as the Modified Adjusted Gross Income (MAGI). The MAGI generally includes all forms of income, and adds back in some of the things you may have deducted on your tax return, including items such as passive or rental losses.
If you feel that your IRMAA rating is incorrect or no longer accurate, you can file an appeal and reduce or eliminate the additional charges. Outstanding circumstances such as the death of a spouse, divorce or marriage, work stoppage or deduction of hours/pay, loss of income from income producing property, or loss/reduction of certain kinds of pension income may qualify you.
This is just the tip of the iceberg of all you need to do for your Medicare coverage. But, don’t stress, Schwenker Senior Insurance is here to help. If you need Medicare guidance or are ready to start comparing options to find the plan that works for you, give us a call at 563-579-6116, or email us at jon@schwenkerins.com.
