Should I Get Part B?

Employer or Union Coverage | TRICARE | CHAMPVA | Medicaid |Health Insurance Marketplace | Health Savings Account (HSA)

Deciding whether or not to start taking your Part B is a common problem. We’ll help you understand if and why you should apply for your Part B when you are eligible. 

Have employer or union coverage?

If you, your spouse, or family member (if you are disabled) is currently working and you have coverage through that employer or union, it can be tough to decide if you should take your Part B.  

As long as your employer or union coverage is considered creditable (meaning it meets the standards of Medicare), you will not be subjected to a Part B late enrollment penalty for as long as you are on that creditable coverage.

Also, keep in mind that Part B carries a premium (the standard premium in 2023 is $164.90 per month), so if you decide to get Part B while you have employer or union coverage, it will be an additional monthly expense.

That said, some people do choose to take their Part B when they qualify for Medicare even though they do not need it due to them already having creditable coverage.  For these individuals, the main concern is having some type of redundant backup coverage and these individuals do not mind paying the monthly Part B premium on top of their creditable coverage’s premium.  

**Coverage based on current employment doesn’t include: COBRA, retiree coverage, VA coverage, or individual health coverage (through the Health Insurance Marketplace) meaning that these programs don’t qualify you to defer your Part B enrollment. 

COBRA - Part B deferment only applies to creditable coverage while you’re working.  Because COBRA is a temporary extension of health benefits after you’ve stopped working, you’ll likely want to apply for Part B before any of your Special Enrollment Periods (SEP) or your Initial Enrollment Period (IEP) ends.  If you are on COBRA and turn 65, then you’ll want to apply for Parts A and B, and your COBRA typically ends once your Medicare begins.**

Retirement and re-entering the workforce?

As with every decision in life, no one can predict the future.  You may be planning to retire soon but decide to get back in the workforce sometime in the future.  If that happens, it’s advisable to take your Part B once you leave your creditable coverage.  

If and when you re-enter the workforce, you can cancel your Part B and join your new employer’s large group health plan.  Once you retire again and subsequently leave your employer’s health plan, you’ll qualify for a Special Enrollment Period (SEP) to choose what you’d like to do again with your Medicare.

Short answer: It’s always best to check with your plan’s benefit administrator.

Employer or Union Coverage | TRICARE | CHAMPVA | Medicaid |Health Insurance Marketplace | Health Savings Account (HSA)

Have TRICARE?

In order to keep your TRICARE, you generally must enroll in Part A and Part B when you’re first eligible. However, if you’re an active-duty service member or an active duty family member, you don’t have to enroll in Part B to keep your TRICARE coverage. For more information, contact TRICARE.

Employer or Union Coverage | TRICARE | CHAMPVA | Medicaid |Health Insurance Marketplace | Health Savings Account (HSA)

Have CHAMPVA?

If you have CHAMPVA coverage, you must enroll in Part A and Part B to keep it. Call 1-800-733-8387 for more information about CHAMPVA.

Employer or Union Coverage | TRICARE | CHAMPVA | Medicaid |Health Insurance Marketplace | Health Savings Account (HSA)

Have Medicaid?

If you have Medicaid, you should sign up for both Part A and Part B. Medicare will pay first, and Medicaid will pay second. Depending on the level of Medicaid you qualify for, Medicaid may be able to help pay your Medicare out-of-pocket costs (like premiums, deductibles, coinsurances, and copayments).

Employer or Union Coverage | TRICARE | CHAMPVA | Medicaid |Health Insurance Marketplace | Health Savings Account (HSA)

Have current coverage through the Health Insurance Marketplace?

You should enroll in Medicare Parts A and B when you’re first eligible to avoid delaying your Medicare coverage start and to avoid Medicare late enrollment penalties. 

Once you’re considered eligible for or enrolled in Part A, you won’t qualify for help through the Marketplace for paying your Marketplace plan premiums or other medical costs. If you continue to get help paying your Marketplace plan premium after you have Medicare, you may have to pay back the help you got when you file your taxes.

Do not forget to cancel your Marketplace coverage in order to avoid an overlap in coverage with your Medicare. 

Visit HealthCare.gov to connect to the Marketplace in your state and learn more. You can also find out how to end your Marketplace plan or Marketplace financial help when your Medicare enrollment begins. You can also call the Marketplace Call Center at 1-800-318-2596. TTY users can call 1-855-889-4325.

Employer or Union Coverage | TRICARE | CHAMPVA | Medicaid |Health Insurance Marketplace | Health Savings Account (HSA)

Have an Health Savings Account (HSA)?

Once your Medicare starts you can no longer contribute to your HSA.  However, you can still use the existing money in your HSA to pay for your Medicare premiums, deductibles, copayments and coinsurance.

If you or your employer contribute to your HSA after your Medicare has begun then you may be subject to tax penalties.

If you’d like to continue contributing to your employer-sponsored HSA without penalty after you turn 65, you shouldn’t apply for Medicare, Social Security, or Railroad Retirement Board (RRB) benefits.

**To avoid a tax penalty, you should stop contributing to your HSA at least 6 months before you apply for Medicare.**

Let our ‘Even Better’ Medicare plan experts help answer the tough questions and get you taken care of today!

Employer or Union Coverage | TRICARE | CHAMPVA | Medicaid |Health Insurance Marketplace | Health Savings Account (HSA)

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