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Medicare: Original Fee-For-Service

Should I Take Medicare Part B Coverage?

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In most cases, a person with a history of a serious health condition who has Original Medicare will want to enroll in Part B Medicare.

It is advisable to take Part B if:

  • Medicare will be your only health insurance plan.
  • You intend to purchase a Medicare Supplement policy (Medigap).
  • You plan to enroll in a Medicare HMO. See Medicare HMO.
  • Your other coverage is a group health plan that integrates with Medicare Part A and Part B "…whether or not you are enrolled in both."

You may not need Medicare Part B if you have another health insurance plan and:

  • The other insurance does not attempt to subtract from its normal benefits any amounts paid by Medicare. Generally group policies follow Coordination of Benefits and individual health policies subtract Medicare benefits from their payment. (See Medicare and Coordination of Benefits)
  • AND
  • The plan covers the same things that Medicare Part B covers such as doctors and lab tests
  • AND
  • Your plan only integrates or considers what coverage you actually have. It won't integrate with Part B unless you're actually enrolled in Part B.

If you do not need Part B coverage now, by postponing it, you protect your right to purchase a Medigap policy on a guarantee issue basis. See Medicare -- Info -- Medigap Policies.

NOTE: It is important that you be sure before you turn down Medicare Part B. If you later need Part B and do not qualify for a Special Enrollment Period, you may be penalized by having to wait to enroll until the Open Enrollment and forced to pay a penalty in addition to each premium payment.

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