Medicare Part B Coverage

Medicare Part B helps cover medically necessary services such as doctors’ services, outpatient care, home health services, and other medical services. Part B also covers certain preventive services.

You can find out if you have Part B by looking at your Medicare card.

How Do You Get Medicare Part B?

If you get benefits from Social Security or the Railroad Retirement Board (RRB), in most cases you are automatically enrolled in Part B starting the first day of the month you turn 65. If your birthday falls on the first day of the month, Part B begins the first day of the prior month.

If you are under age 65 and disabled, you are automatically enrolled in Part B after receiving disability benefits from Social Security or certain disability benefits from the RRB for 24 months. You will receive your Medicare card about three months before your 65th birthday or your 25th month of disability.

If you do not want Part B, follow the instructions that come with your Medicare card and send the card back. If you keep the card, you keep Part B and will be responsible for paying the monthly Part B premium.

If you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig’s disease), you are automatically enrolled in Part B the month your disability benefits begin.

When Can You Sign Up for Part B?

If you didn’t sign up for Part B when you were first eligible, you may be able to enroll during one of the following periods:

General Enrollment Period (GEP)

• January 1 – March 31 each year
• Coverage begins July 1
• Late enrollment penalties may apply

Special Enrollment Period (SEP)

You may qualify for a SEP if:

• You or your spouse are currently working, and you’re covered by a group health plan based on that employment; or
• You are disabled and covered under a group health plan based on your own or a family member’s current employment

You can enroll anytime while you have qualifying coverage, or during the 8-month period that begins after employment or group health coverage ends (whichever happens first).

Important: COBRA coverage does not extend this Special Enrollment Period. This SEP does not apply to individuals with End-Stage Renal Disease (ESRD).

Special Enrollment Period for International Volunteers

If you delayed Part B enrollment because you had health coverage while volunteering outside the U.S. for a tax-exempt organization for at least one year, you may enroll during the 6-month period after:

• Your volunteer service ends,
• The organization loses tax-exempt status, or
• Your foreign health coverage ends.

Part B and ESRD

If you have Medicare due to End-Stage Renal Disease (ESRD), you can sign up for Part B when you enroll in Part A. If you delay enrollment, a late enrollment penalty may apply.

Important Note About Late Enrollment Penalties

If you don’t sign up for Part B when first eligible and don’t qualify for a Special Enrollment Period, your monthly premium may increase by 10% for each full 12-month period you could have had Part B but didn’t enroll. In most cases, this penalty lasts as long as you have Part B.