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Here What Others Have to Say

“Margo helped make the transition to Medicare and supplemental insurance so easy. She simplified the process and in one meeting I had medical, prescription plan, dental and vision covered. I highly recommend her. Thank you, Margo.”

Leslie W

“My husband and I met with Karl several times. It is comforting to be able to tap his expertise in the oh so confusing Medicare process. I read a lot of paperwork I was bombarded with and did some research on-line also. Having Karl’s direction gives me peace of mind. I would recommend him to anyone!”

Karen D.

“Margo was very efficient and informed in helping us with our Medicare Advantage Insurance Plan. She helped us make the correct decision as well as doing all the paper work for us, much easier than going it alone. We would recommend the Steinlage Insurance Agency.”

Bryce D.

Medicare Part B FAQs

How does Medicare Part B differ from Part A?

  • Medicare Part A covers Hospitalization services and is typically provided at no charge.
  • Medicare Part B covers Outpatient services (like MRI’s, doctor visits) and is premium based.
  • The monthly premium is determined annually by the government and will likely rise over time. There is also an income adjustment called IRMAA for certain individuals making over $85k individual or $170k for husband/wife.

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How much does Medicare Part B cost?

  • In 2018, the base Medicare Part B premium is $134/mo per person. This premium is either billed quarterly to you if you are not drawing SS benefits or taken directly out of your SS check.
  • If you plan on delaying SS until a later date (like age 70), you may wish to have the Medicare Part B premiums drafted out of your checking account by using this document.

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What does Medicare Part B cover?

  • In layman’s terms, Medicare Part B has an annual deductible of $183 for 2018 and then provides 80% coverage for outpatient services like ambulance rides, X-rays, ER visits, PT/OT, and much more.
  • Medicare Part B is extremely liberal in what it covers.
    • For example, if you have a $5000 PET scan, Medicare Part B would pay $3,853.60 ($5,000 – $183 = $4,817 X 80%).

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Who qualifies for Medicare Part B?

  • You must be 65 or older.
  • You must be a citizen or a permanent resident lawfully residing in the U.S. for at least five continuous years.
  • If someone deferred Part B at their 65th birthday and maintained creditable coverage from a job/retiree plan, spouse’s coverage, or another source, they will have a special enrollment period to enroll in Part B once that coverage terminates. There are specific instructions that follow if the client is on COBRA before or after turning 65.

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What are some things to consider when looking into Medicare Part B?

  • Many clients will enroll during their 7-month, Initial Enrollment Period.
  • If you are employed full-time and your employer has 50 or more employees then you may defer Part B.
  • We will compare and contrast your pricing and recommend a time frame for your Part B enrollment.
  • If you are a high earning individual, you may have a higher Part B premium due to IRMAA/income related penalty. The IRMAA penalty may affect your Part B enrollment timing.

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What happens if I can’t afford Medicare Part B?

  • There are programs that assist with Medicare Part B premiums.
  • The Qualified Medicare Beneficiary (QMB) and Specified Low Medicare Beneficiary (SLMB) programs assist with Part B premiums and require three general eligibility requirements:
    • Be enrolled in Part A Medicare (hospital insurance).
    • Have resources not exceeding the QMB/SLMB resource maximums of $7,560 for an individual, and $11,340 for a couple.
    • Have income not exceeding the QMB/SLMB standard of the Federal Poverty Level for assistance group size.

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When and how do I sign up for Medicare Part B?

  • Typically a client will enroll in Medicare during their initial enrollment period.
  • The initial enrollment period is 3 months prior to the client’s 65th birthday, the clients 65th birthday month, and the 3 months following the 65th birthday month. If you turn 65 in June, your initial enrollment period is March-September.
  • We recommend signing up in the 3-month window prior to turning 65 to avoid any delays. You can sign up directly at the Medicare office/social security office or go to www.ssa.gov and enroll directly online.
  • If a client enrolls in Part A at 65 but defers Part B because the client has credible coverage from a job/retiree plan, spouse’s coverage, or another source, the client may have a special enrollment period that will allow the client to enroll in Part B at a later date.
    • To enroll under this method, there are two specific forms that need to be completed and mailed to the social security office. These forms can be found here.
  • We always recommend completing the forms 2-3 months from the desired Part B effective date.

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What coverage changes can I make to Part B during the Open Enrollment?

  • Changes made during this period are for Part D and Medicare Advantage plans. You can switch from Medicare Advantage plans to Original Medicare with a Part D plan or you can simply rate shop your current Part D plan.
  • It’s important to note, during Open Enrollment your Part B premium will maintain the status quo. Changes made to Part D or MAPD during Open Enrollment Period will not affect your part B premium.

 

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Can Medicare Part B be canceled?

  • Yes, Medicare Part B can be canceled if you do not pay your monthly premiums.
  • Also, if you decide to go back to work and your employer-sponsored coverage is better than your Medicare coverage, you may decide to proactively terminate your Medicare Part B coverage. However, this must be done in person at an SS office.

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What are Medicare Part B premiums?

  • The monthly premium is determined annually by the government and will likely rise over time.
  • There is also an income adjustment called IRMAA for certain individuals making over $85k individual or $170k for husband/wife.
  • In 2018, the base Medicare Part B premium is $134/mo per person. This premium is either billed quarterly to you if you are not drawing SS benefits or taken directly out of your SS check. If you plan on delaying SS until a later date (like age 70), you may wish to have the Medicare Part B premiums drafted out of your checking account by using this document.

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Does Medicare Part B qualify as minimum essential coverage?

  • Yes! If you have Medicare A/B, you have met the requirements of the Affordable Care Act (Obamacare) and have creditable coverage.
  • Said another way, if you have a red, white, and blue Medicare card, you will not be charged a tax penalty by the government because you didn’t enroll in a Marketplace plan.

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Are Medicare Part B premiums tax deductible?

  • Yes, Medicare premiums are deductible as a medical expense if you meet certain conditions required by the IRS.
  • With the recent changes in tax law, we recommend you consult your accountant to confirm.

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