Medicare Part B is the 'doctor bill insurance' part of Medicare.
Medicare Part B medical Insurance helps pay for physicians' fees in and outside the hospital and outpatient services such as durable medical equipment, ambulance services and laboratory tests. The government pays 75 percent of the premiums, making it low-cost insurance for most enrollees. Recipients have the right to terminate coverage. Withdrawal may be advantageous if Part B duplicates other insurance or the beneficiary plans to permanently leave the United States.
Rules During IEP
When individuals approach age 65, they can apply for Medicare Part B during their initial enrollment period (IEP). The 7-month IEP starts 3 months before and ends 3 months after the month the recipient turns 65. If the recipient applies for Part B during her IEP and then decides to cancel, she must file a request for withdrawal on form CMS-1763 Request for Termination of Medical Insurance Benefits, before the month in which coverage will start. Coverage may begin several months after age 65 if the person applied late in their IEP.
Automatic Enrollment Rules
The Social Security Adminstration automatically enrolls current beneficiaries in Medicare as they approach age 65 or their 25th month of eligibility for social security disability benefits. These recipients can refuse Part B enrollment without penalty any time through the last day of the second month after the month the beneficiary receives notification of automatic enrollment in Part B. Special enrollment and withdrawal rules apply to recipients who qualify for Medicare because of end-stage renal disease.
Terminating Existing Coverage
Part B recipients can withdraw at any time. Coverage ends effective the month following the calendar month in which Social Security receives their written and signed request, either on form CMS-1763 or in a letter that makes their withdrawal intent completely clear. A request submitted in July 2010 terminates coverage and payment at the end of August.
Rules Forbidding Withdrawal
Most states pay the Part B Medicare premium for their recipients of Medicaid---the low-income medical insurance program administered at the state level. Since the state pays the premiums, the Part B recipient cannot withdraw from coverage. Medicare beneficiaries who belong to a Medicare Advantage plan--such as a health maintenance organization (HMO) or preferred provider service (PPS)---cannot disenroll from Part B without canceling their Medicare Advantage plan. Some individuals did not work enough under Social Security to receive Medicare's Part A Hospital Insurance premium-free. If they have purchased Medicare Part A, they must also stay enrolled in Part B or lose both parts of Medicare.
Re-Enrollment Options
If a beneficiary withdraws from Part B because it duplicated coverage from the group health plan through his or his spouse's employer, he may re-enroll without penalty or coverage delay if the group plan terminates and he meets the requirements for a special enrollment period. If he does not qualify for an SEP, he can only re-enroll during the general enrollment period, January, February and March of each year. Coverage begins July and premiums increase 10 percent for each 12 months he could have been enrolled in Part B but was not.
Tags: Medicare Part, Social Security, enrollment period, after month, enrolled Part, form CMS-1763, from Part
