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Ask Ben: My Spouse and I Want to Enroll in Medicare Part B. What Are Our Options?

In Ben Spec, Benefits and Employment Articles, Featured, News by Ben Spec

Good morning young Hobbits! I am at a Hobbiton where they filmed parts of the Lord of the Rings movies here in Matamata, New Zealand. Even though I still feel hungry even after my second breakfast, I’ll answer a question from Jane and Keisha.

Hey Ben – My spouse and I want to enroll in Medicare Part B. Neither of us have that coverage, and we’ll soon need it. I had insurance through my job, and Keisha could have signed up for it a few years ago, but didn’t. What choices do we have in the coming months?

Jane and Keisha


Dear Jane and Keisha – this is exactly the right time to be asking that question!

January 1 through March 31 each year is the General Enrollment period for Medicare Parts A (hospital insurance) and B (out-patient services).  During this period, you can enroll in Part A and/or Part B if you did not do so when you first were eligible. Your coverage will begin July 1.

Part A and Part B Premiums

Most people don’t have to pay a premium for Part A so I won’t go into that.  Part B, however, does charge a premium to everyone. The Part B premium for most people who enroll in 2019 is $135.50.  People with income above $85,000 (single) or $170,000 (married couple) will have higher premiums.

Premium Penalties

Some people will pay a higher premium (a “penalty”) if they did not enroll when they were first eligible, or will be charged more if they have high incomes.

Jane, you will not have to pay a premium penalty for Part B since you have been covered under your employer’s group plan.

Keisha, you may have to pay a premium that is 10% higher for every year you were eligible for Medicare but did not enroll. There are some situations when you do not have to pay that penalty. In Wisconsin, the Medigap Helpline (1-800-242-1060) can help you with that and other information regarding Part B.

Other Options During Open Enrollment

Though the following options don’t apply to you two, other readers may want to know that during the Open Enrollment Period you can also:

  • change your Advantage Plan (Part C) to a different Advantage Plan.
  • drop your Advantage Plan and enroll in original Medicare. If you do that, you also can enroll in a Part D (prescription drug coverage) plan if you choose. You can get more information on Part D plans available in Wisconsin through these resources:

MediGap: Help Paying for Other Costs

One or both of you might be interested in a Medicare Supplement, or “Medigap”, policy.  Medigap policies help pay some of the health care costs that Original Medicare doesn’t cover, such as copayments, coinsurance, and deductibles.  You will have an “Open Enrollment Period” for purchasing a Medigap policy for the 6 months following your first enrollment in Part B. Companies have to sell you a policy during this period no matter what health issues you have.

With Medigap, there could be a delay in coverage for preexisting conditions if you did not have recent “creditable” coverage.  Also, Federal law doesn’t require insurance companies to sell Medigap policies to people under 65.

Wisconsin, along with 32 other States, requires insurance companies to offer at least one kind of Medigap policy to people with Medicare under 65. The Medigap Helpline can help you explore your Medicare Supplement options.

I hope this answers your questions, Jane and Keisha. If not, feel free to use the link below to follow-up with me, or get more information directly from the Medigap and Part D Helplines and resources.

I’m glad you’ll have health insurance!

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