Updated 25 Jan 2024 
3 Minute Read
Can you imagine having a heart attack? Then you need open heart surgery! Imagine not having any coverage, meaning you would have to pay 100% for the cost of surgery.
If you fail to enroll in Medicare Part B, this could happen to you, and it is quite surprising how often this does happen. Every year people misunderstood or were given wrong information by Social Security regarding what was needed. Then they end up with a significant health issue only to learn they can’t pay for the care required.
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So, if the question is – Do I need Medicare Part B?
You can avoid unexpected medical bills by enrolling in Part B when Medicare is primary. Once retired and you now have no access to other types of health coverage, then Medicare will become your primary insurance. Part A will pay for room and board when in the hospital, but Part B covers many things happening both inside and outside the hospital. For example, part B will provide 80% coverage on lab work, doctor visits, medical equipment, therapy, diabetes supplies, and surgeries, plus radiation, dialysis, and more.
When Medicare is primary, it’s a critical component in your overall health package.
Here are some scenarios commonly found when Medicare is primary:
- 65 or over, employer coverage with a company that has less than 20 employees
- Under 65, on Medicare due to disability, then work for any employer who has under100 employees.
- Retiree coverage which came from your former employer
- COBRA Insurance – you have to enroll in Medicare Part B (by the 8th month of COBRA)
- If you are turning 65 and have (TFL) Tricare for Life, or CHAMPVA
- 65 or older – and enrolled in Medicaid
These are all different scenarios requiring you to enroll in Medicare Part B. If you are without Part B, you are responsible for the first 80% for all your outpatient charges. To make things worse, if you’re not actively enrolled in Part B for your primary coverage, your secondary coverage may not pay at all.
You must first enroll in Medicare Part B to make your Employer, retiree, COBRA, TFL, and Medicaid coverages your secondary insurance. You may also be required to pay a penalty if you choose to enroll at a later date.
At some point, most people do need Part B. The time to enroll depends on the different types of coverage you currently have when turning 65. Plus, Part B is not a supplement, and you need Medicare Part B before enrolling in a Medicare Advantage Plan or Medigap. Remember, Medicare costs and is only free if you qualify for Medicare Savings Programs because of low-income circumstances. While you will have to pay a premium for Part B, it does provide a huge percentage (80%) of all outpatient expenses. Make sure you seek the help of a professional when making these decisions and enroll before it is too late.
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