Reasons Why You Shouldn't Enroll in Medicare Part B

Here are a few scenarios why retirees should consider not taking Part B. 

  • High Income Couples and Individuals that pay IRMAA—If you fall into one of the high-income categories (more than $97,000 individual or $194,000 couple), Part B is of limited value due to the increase in the Part B Premium.
  • Plans that don't coordinate well with Medicare—Some FEHB plans have better Medicare coordination benefits than others, including those that have partial Part B premium reimbursement. If you're with a plan that doesn't coordinate well with Medicare, you're probably better off not taking Part B.

  • Duplicative insurance—If you don't want to pay two premiums—one for your FEHB plan and one for Part B—it's perfectly reasonable to not enroll in Part B. Part B will rarely save you nearly as much money as you spend on the Part B premium. For most FEHB plans, the yearly cost estimate is lower if you're in Part A only vs Parts A & B. This is because the cost-sharing for physician visits and tests in almost all FEHB plans is already so low.

  • Provider cost—Once you reach age 65, a special rule applies whether you enroll in Medicare Part B or not. It is illegal for doctors who have not opted out entirely from Medicare to charge patients covered by Medicare more than a limiting charge. This restriction applies to all FEHB retirees over age 65, whether they have Medicare or not. Under this provision, you will not be exposed to high charges that neither Medicare nor your FEHB plan recognizes as reasonable. You do not have to sign up for Medicare Part B to get this guarantee. Therefore, unlike employees, if you are over 65 you can use non-preferred providers without fear of being charged substantially more than the plan will recognize as reasonable. You must, of course, pay higher deductibles and coinsurance if the provider is not in your plans network.

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