Compare Your Medicare Part B Options

Need to find the best Medicare Part B? Use this quick reference to see what your Medicare Part B options are.

Medicare is health insurance offered by the U.S. federal government for citizens who are 65 years of age or older. It is also for those who are mentally, physically, or otherwise disabled. Those receiving Medicare are often confused by the options, qualifications and what is, or is not, covered. This confusion stems from the fact that Medicare is multi-faceted and has four major parts: A, B, C, and D. These different parts govern different types of services and each may be offered through different carriers. If you have elected for a traditional Medicare coverage, then parts A and B are included in that. However, if you have opted for Medicare Advantage (often referred to as Part C) then your choices expand significantly. Here’s how to make sense of Medicare Part B and the options you have.

How Medicare Works

Medicare is primarily for seniors and was developed so that retired U.S. citizens would be provided for during their golden years. This is because seniors 65 years of age or older are more prone to illness, injury or accidents. The Medicare program is administered by the same U.S. federal department that oversees the Social Security Administration. In most plans, you have the basic minimum coverage for doctor’s visits and short term stays in the hospital. The traditional Medicare plan does not offer coverage for dental or vision. If you prefer to have dental and vision, then you want to sign up for Medicare Part C. Part C, also called the Advantage Program, allows you to select your Part B provider and to select whom you prefer for dental and vision services.

What is Medicare Part B?

It is often stated that Medicare Part B is optional. However, in most instances it really is not optional. First, if you opt not to take on Part B, then change your mind, there are penalties applied. These penalties are not one-time penalties but are like “late fees” attached to your premium bill every month. Secondly, some plans require you to have Part B, and therefore it is not optional at all.  The only way postponing your Part B coverage works for you is if you can prove “credible coverage”. Credible coverage means you, or your spouse, are still covered through your workplace. If the following is true for you, then you must select a Medicare Part B plan:

  • Your workplace consists of 20 or fewer people.

  • You are only covered by VA coverage.

  • You do not currently have traditional medical insurance and are using cost-sharing.

  • You want to enroll in Medicare Advantage.

  • You want to enroll in Medicare Supplement plans.

  • You want to enroll in TRICARE for Life policies.

Medicare Part B covers outpatient services such as annual exams or a visit to the doctor. It pays at least 80% of these costs. The average premium per month is around $148. However, the cost of the premium can change from year to year. It is determined on your adjusted gross income, tax returns, congressional decision, and your tax bracket.

Medicare Part B Options

Medicare Part B covers services such as doctor’s visits, as well as preventative wellness exams and lab tests. It covers medical supplies such as walkers, surgical braces, or oxygen tanks. Part B also covers you in the event you need treatments, such as dialysis, cancer treatments or other chronic conditions. A complete list of what Medicare Part B covers is available through the federally run Medicare website.

Option One: go with traditional Medicare.  In this option you do have the ability to postpone Part B. This is a good option to select if you still have coverage through your, or your spouse’s, workplace. Otherwise, when you eventually need it you will pay a penalty.

Option Two: go with Medicare Advantage. The benefit is that you have additional coverage for vision and dental. However, you do not have the option of postponing Part B.

Medicare Insurance Companies

The following health insurance providers offer Medicare plans. You will see that there is a wide variation in the fees, coverages, and premiums. It is of benefit to compare them side by side. In general, when looking at the policies, compare their out-of-pocket costs for hospital stays, and see if there is any provision made for long term care, as well as skilled nursing assistance. The rule of thumb is that if the monthly premium is higher, then your out-of-pocket costs are lower. Here are the top 4 carriers in the U.S.  Note that not all these providers may be available in your state.

United Health Group

As one of the largest healthcare organizations, United has 1.3 million doctors and health professionals with whom they have a partnership. Nearly 6,500 hospitals accept their insurance nationwide.

Humana

Human has received numerous awards for their products and services. Among Medicare plans they are often the most affordable. They do require you to select providers from within their network only, and some medications are not covered. Make sure to directly ask if your medications are included in their coverage.

Cigna

Cigna offers the most flexible of Medicare Part B options. With over a million associated medical and healthcare professionals they are able to offer comprehensive coverages for many items not covered by other providers. Their online platform is one of the easiest to navigate as well.

Aetna

Aetna was originally a life insurance company that expanded its services to include healthcare insurance products. Aetna is not available in many states, so you must check their coverage areas. Those areas serviced by Aetna enjoy greater flexibility with selection of doctors, and many of the prescription drugs not covered in other plans, are covered by Aetna.

Medicare Open Enrollment

When you first turn 65 years old you are eligible to enroll under a special condition enrollment period. Thereafter, you must wait to make changes to your Medicare plan until the open enrollment period. The enrollment period runs from October 15-December 7th every year. If you have postponed enrollment into a Part B plan, this is when you would add it to your plan. Changes go into effect the month following enrollment. So, for example, if you enrolled or made changes on Oct 15th, then on November 1st your changes go into effect.