Should I get Part B?

This information can help you decide if you should get Part B based on the type of health coverage you may have.

Employer or union coverage
If you or your spouse (or family member if you have a disability) is still working and you have health coverage through that employer or union, contact your employer or union benefits administrator to find out how your coverage works with Medicare. This includes federal or state employment and active-duty military service. It might be to your advantage to delay Part B enrollment.

Coverage based on current employment doesn’t include:
• COBRA
• Retiree coverage
• VA coverage
• Individual health coverage (like through the Health Insurance Marketplace)

TRICARE
If you have TRICARE (health care program for active-duty and retired service members and their families), you generally must enroll in Part A and Part B when you’re first eligible to keep your TRICARE coverage. 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.

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.

Medicaid
If you have Medicaid and don’t have Part B, Medicaid may help you enroll.  Medicare will pay first, and Medicaid will pay second. Medicaid may be able to help pay your Medicare out-of-pocket costs (like premiums, deductibles, coinsurance, and copayments).

Health Insurance Marketplace
Even if you have Marketplace coverage, you should enroll in Medicare when you’re first eligible to avoid the risk of a delay in Medicare coverage and the possibility of a Medicare late enrollment penalty.

Here are some important points to consider if you have Marketplace coverage:
• You need to terminate (end) your Marketplace coverage in a timely manner to avoid an overlap in coverage.
• Once you’re considered eligible for or enrolled in Part A, you won’t qualify for help from the Marketplace to pay your Marketplace plan premiums or other medical costs. If you continue to get help to pay your Marketplace plan premiums after you have Medicare, you may have to pay back the help you got when you file your taxes.

Visit HealthCare.gov to connect to the Marketplace in your state and learn more. To find out how to end your Marketplace plan or Marketplace savings when your Medicare coverage begins, visit HealthCare.gov/medicare/changing-from-marketplace-to-medicare. You can also call the Marketplace Call Center at 1-800-318-2596. TTY users can call 1-855-889-4325.

Health Savings Accounts (HSA)
To avoid a tax penalty, you should make your last HSA contribution the month before your Part A coverage begins. Premium-free Part A coverage begins 6 months before the month you apply for Medicare, Social Security, or Railroad Retirement Board (RRB) benefits, but no earlier than the month you turn 65.
• If you apply for Medicare during your initial enrollment period (IEP) or during the 2 months after your IEP ends, you should make your last HSA contribution the month before you turn 65.
• If you wait to enroll in Medicare less than 6 months after you turn 65, you can avoid a tax penalty by stopping HSA contributions the month before you turn 65.
• If you wait to enroll in Medicare 6 or more months after you turn 65, you can avoid a tax penalty by stopping HSA contributions 6 months before the month you apply for Medicare.

from Medicare and You Handbook 2021, pages 19-20

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