Medicare Part B or the doctor’s “Medical Insurance” pays when you visit your doctor in their office and other outpatient care. If you need to enroll in Medicare Part B here is what you need to know.
General Enrollment vs. Special Enrollment
General Enrollment is only open to the public January through March of each year. If you do not qualify for Special Enrollment (see below) your only option for enrolling in Medicare Part B will be the General Enrollment period. To sign up you need to fill out the General Enrollment form, HCFA-40b. (HCFA is pronounced hick-fah) You can pick up this form at your local Social Security office or have one mailed to you by calling Social Security’s toll free number.
The problem with the General Enrollment period, other than the fact that it only opens January through March, is that your Medicare Part B coverage will not start until July 1st of that year. Additionally, if you declined the Part B coverage originally and did not have group health insurance due to employment, (your employment of a family member’s) you can be charged a premium surcharge penalty. This penalty is 10% of the Medicare Part B premium amount for each year you were not enrolled in Medicare.
The Medicare Part B premium for 2006 is $88.50 per month. If you were out of Part B for one year the penalty would be 10% or $8.85. Your monthly premium for Part B coverage would then be $97.35 per month. As you can see, enrolling under General Enrollment can become quite expensive if you are assessed a penalty on your premium amounts.
Qualifying for Special Enrollment
Special Enrollment for Medicare Part B is available to qualified beneficiaries any time of the year. The coverage can be effective immediately and you will not have to wait until July as you would under General Enrollment. To sign up under special enrollment you need a Special Enrollment package, which is available from your local Social Security office or by calling the toll-free number.
To be eligible for Special Enrollment under Medicare Part B you need to have been covered by a group health plan due to current employment. The employment can be yours or that of a family member; as long as you are covered by that health insurance you are eligible for Special Enrollment. The catch is that the health plan must be due to current employment. You or your family member must actually be working; retirement policies do not satisfy this work requirement. If you are retiring and your policy is shifting from work to a retirement policy, you have a six month window to sign up for Medicare Part B. You are allowed three months before you stop work and three months after stopping work to enroll.
If you do not qualify for Special Enrollment and have to sign up under General Enrollment you must have the paperwork submitted prior to March 31st. For more information about your enrollment options, contact Social Security at their toll-free number: 1-800-772-1213.