Medicare Part B Coverage
Q. Do I Have to Take Part B Coverage?
A. 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.
Q. How Much Does Part B Coverage
A. The standard monthly premium for Medicare Part B in 2007 increased to $93.50 from $88.50. Effective January 1, 2007, the government started determining the Medicare Part B premium based on a person’s income. Higher-income beneficiaries for the first time will pay a higher monthly premium than other beneficiaries, as ordered by a provision in the 2003 Medicare law. Under the provision:
- Individuals with annual incomes under $80,000 and married couples with annual incomes under $160,000 in 2007 will pay a monthly premium of $93.50;
- Individuals with annual incomes between $80,000 and $100,000 and married couples with annual incomes between $160,000 and $200,000 in 2007 will pay a monthly premium of $106;
- Individuals with annual incomes between $100,000 and $150,000 and married couples with annual incomes between $200,000 and $300,000 in 2007 will pay a monthly premium of $124.70;
- Individuals with annual incomes between $150,000 and $200,000 and married couples with annual incomes between $300,000 and $400,000 in 2007 will pay a monthly premium of $143.40; and
- Individuals with annual incomes of $200,000 or more and married couples with annual incomes of $400,000 or more in 2007 will pay a monthly premium of $162.10.
Q. What Happens If I Don't Take Part B
as Soon as I'm Eligible?
A. 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. Your Part B premiums will go up 10 percent for each 12
months you could have had Part B but didn't take it.
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 increased premiums) 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.