Eligibility, Costs and Penalties

To be eligible for Part B and pay what most individuals pay you must work 10 years and pay taxes be 65 years or older, or under 65 and have been on disability for 24 months.  Enrollment in Medicare Part B is automatic if you are on Social Security when turning 65.  If you are waiting for your full retirement age (FRA) to take social security and DO want to enroll in Medicare Part B, you can go online to medicare.gov create an account and sign up or go to the local Social Security office.

For most individuals Medicare Part B has a monthly premium cost of $174.70 for 2024.  There are individuals with higher incomes will pay more in a tiered system called IRMAA the acronym for Income Related Monthly Adjustment Amount.  Show me IRMAA

There is a penalty for not taking Part B when first eligible when turning 65 or eligible through disability.  The Medicare Part B penalty is 10% of the cost of Part B ($174.70) to avoid this penalty you must be employed with union/group/employer sponsored coverage when you become eligible for Part B.  If you retired early and are on COBRA this coverage is not considered credible coverage and you still need Part B.

Medicare Part B works much like your traditional major medical health insurance does, after the annual deductible.

• Medicare Part B deductible is $240 for 2024
• Medicare pays 80% of eligible costs
• You pay 20% of the eligible costs.  Doctors and service providers are allowed to charge up to another 15% more than Medicare allows this is referred to as an “Excess Charge”.
• Medicare pays 80% of the cost for Part B Drugs (drugs administered in a Doctor’s office such as infusion drugs and chemotherapy drugs and you pay the remaining 20%.

It is important to add there are no Maximum Out Of Pockets (MOOP) for Medicare Part B.

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