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Do I Have to Pay a Premium for Medicare Part B Coverage?

Updated: Oct 28, 2023


Do I have to pay a premium for Medicare Part B

When you sign up for Part B medical insurance, Medicare helps pay for doctor visits, preventive care, lab tests, durable medical equipment, and other outpatient services. When you first enroll in Medicare at age 65, one common question is whether Part B requires paying a monthly premium cost.


The short answer is yes - most people do have to pay Medicare Part B monthly premium. However, some beneficiaries may qualify for financial assistance to help cover their Part B costs.


Continue reading to learn what the Medicare Part B premium will be in 2023, what factors affect how much you pay, and how to get help with premium expenses if eligible.


What Does Medicare Part B Cover?

Before looking at the costs, it helps to understand the coverage provided by Medicare Part B. This part of Medicare coverage helps pay for:

  • Doctor office visits, including annual wellness visits

  • Outpatient hospital services

  • Preventive care screenings like cancer screenings and vaccines

  • Lab tests and diagnostic imaging

  • Durable medical equipment (walkers, wheelchairs, oxygen, etc)

  • Ambulance transportation

  • Mental healthcare like counseling and therapy

  • Many prescription drugs administered in a doctor's office

So Part B covers a wide range of common medical services needed by seniors and other Medicare beneficiaries. It works hand-in-hand with Part A which covers hospital stays and inpatient care.


Having both Part A and Part B is required if you want to add supplemental coverage like a Medicare Advantage Plan. So it's important to understand the costs of Part B when making Medicare premium enrollment decisions.


What Is the Medicare Part B Premium in 2023?

The standard monthly premium for Medicare Part B in 2023 for most beneficiaries is $164.90. This means you'll pay $164.90 per month throughout the entire year for your Part B coverage.


However, if your income is above a certain level, you may pay a higher Part B premium based on the income-related monthly adjustment amount (IRMAA) surcharges:


So higher earners pay between $67 to $267 extra per month for their Part B coverage. The Social Security Administration uses your most recent tax return to determine if you'll pay the standard premium or a higher IRMAA amount.


If you disagree with the IRMAA assessment, you can appeal by submitting documentation showing a decrease in income or filing an amended tax return.


Are Some People Eligible for Premium-Free Medicare Part B?

Yes, some groups of Medicare beneficiaries can qualify for Medicare Part B at no cost:

  • Those who have low incomes and limited assets and qualify for Medicaid or a Medicare Savings Program. Medicaid programs in each state pay the Part B premium on their behalf.

  • Disabled individuals under 65 receiving Social Security Disability benefits. Their Part B premium gets deducted from their disability check.

  • People over 65 who have limited Social Security credits from work. Their premium gets deducted from Social Security.

  • Government retirees who worked for the railroad industry. Part B is premium-free based on years of railroad service.

So even though most people pay a monthly premium for Part B, some Medicare enrollees meet eligibility requirements to have the premium fully covered.


What Happens If I Don't Enroll in Part B When First Eligible?

If you don't sign up for Medicare Part B when initially eligible such as when you turn 65, you'll face some consequences:

  • You can only enroll during the General Enrollment Period from January 1 to March 31 each year. Coverage won't begin until July 1.

  • You may have to pay a late enrollment penalty equal to 10% of the standard premium for every 12 months you delayed enrolling. This penalty is permanent as long as you have Part B.

  • You could have gaps in health coverage if you don't have other insurance. Many Medicare Supplement or Medicare Advantage Plans require you to have Part B.

Unless you have qualifying coverage through an employer, it's wise to enroll in Medicare Part B during your initial enrollment period to avoid penalties and coverage interruptions.


Can I Get Help Paying My Part B Premium if I Have Limited Income?

Yes, Medicare has programs to assist beneficiaries with low income and assets that make it hard to afford their out-of-pocket medical costs, including Part B premiums:

  • Medicare Savings Programs: Medicaid programs in your state that may cover Part B premiums and other out-of-pocket costs if you meet income and asset limits.

  • Extra Help: Provides financial assistance with Medicare Part D prescription drug plan costs which can include help paying your Part B premium.

To find out if you're eligible and apply for assistance, contact your local Medicaid office or Social Security. These programs can reduce the burden of paying premiums and other medical bills.


Key Takeaways on Medicare Part B Premium Costs

While most Medicare beneficiaries must pay a standard monthly premium for Part B coverage, key points to remember include:

  • Higher income seniors pay IRMAA surcharges ranging from $67 to $267 extra per month.

  • Some low-income enrollees qualify to have their Part B premium covered in full.

  • Failing to sign up when first eligible leads to lifelong late enrollment penalties.

  • Assistance programs like Medicaid and Extra Help are available for those who struggle to pay premiums.

  • The standard Part B premium is $164.90 per month in 2023 for most people.

Review the costs and coverage to determine if Medicare Part B is right for your health and financial needs upon turning 65. Know your premium obligations and assistance options.


We’re Here to Help

You do not have to spend hours reading articles on the internet to get answers to your Medicare questions. Give the licensed insurance agents at Lane Financial Strategies a Call at (804) 897-2170. You will get the answers you seek in a matter of minutes, with no pressure and no sales pitch. We are truly here to help.


FAQs


Do I have to pay a premium for Medicare Part B?

Yes, you have to pay a premium for Medicare Part B. The premium amount may vary based on your income and is subject to annual adjustments. However, most people who have paid Medicare taxes for at least 10 years do not have to pay a premium for Part A, but they still have to pay a premium for Part B.


How much does Medicare Part B cost?

The cost of Medicare Part B varies based on your income. In 2022, the standard monthly premium for most people is $170.10. However, if your income is above a certain threshold, you may have to pay an income-related monthly adjustment amount (IRMAA) in addition to the standard premium.


What is Medicare Advantage?

Medicare Advantage, also known as Part C, is an alternative to Original Medicare (Parts A and B) offered by private insurance companies approved by Medicare. Medicare Advantage Plans provide the same coverage as Original Medicare and often include additional benefits such as prescription drug coverage.


How do I apply for Medicare?

You can apply for Medicare online through the Social Security Administration's website or by visiting your local Social Security office. The process is generally straightforward and requires you to provide personal information and documentation to prove your eligibility.


How do I apply for Medicare Part B?

To apply for Medicare Part B, you can complete the enrollment form (CMS-40B) and submit it to the Social Security Administration. You can either mail the form or visit your local Social Security office to apply in person. It's recommended to apply for Medicare Part B during your Initial Enrollment Period to avoid any late enrollment penalties.


What is a Medicare Advantage Plan?

A Medicare Advantage Plan is an all-in-one alternative to Original Medicare (Parts A and B) offered by private insurance companies approved by Medicare. These plans provide the same coverage as Original Medicare and often include additional benefits such as prescription drug coverage, dental, vision, and hearing services.


What is Original Medicare?

Original Medicare consists of Part A (hospital insurance) and Part B (medical insurance). Part A helps cover inpatient hospital stays, skilled nursing facility care, and certain home health care services. Part B helps cover medically necessary services, preventive services, and outpatient care.


How do I enroll in Medicare?

A: You can enroll in Medicare online through the Social Security Administration's website or by visiting your local Social Security office. You can enroll during your Initial Enrollment Period, which generally starts three months before your 65th birthday month and ends three months after your birthday month.


Does Medicare Part B cover prescription drugs?

No, Medicare Part B does not cover most prescription drugs. However, you can get prescription drug coverage by enrolling in a standalone Medicare Part D Plan or by choosing a Medicare Advantage Plan that includes prescription drug coverage.


What is Medicare Supplement insurance?

Medicare Supplement insurance, also known as Medigap, is private health insurance that helps cover the gaps in Original Medicare (Parts A and B) coverage. It can help pay for certain out-of-pocket costs like deductibles, copayments, and coinsurance. Medicare Supplement Plans are sold by private insurance companies and work alongside your Original Medicare benefits.

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