Medicare Part B Disadvantages

Medicare, a federal health insurance program first established in 1965, is meant mainly to help senior citizens, but some people under the age of retirement may also use it--if they have certain diseases or disabilities. As of 2010, Medicare has four official parts: A, B, Medicare Advantage (C) and D. Parts A and B are known as traditional Medicare. Part A mostly covers inpatient hospitalizations, hospice and home health services. If you receive Part A, you are eligible for Part B as well, which offers preventive and medically necessary services, such as health screenings, wellness programs and rehabilitation. However, many people believe Part B comes with its own set of disadvantages.

Premiums

• If you have paid 10 years of Social Security taxes or have been a federal or state employee, you qualify for premium-free Medicare Part A. Part B, however, always requires monthly premium payments. As of 2011, the standard Medicare Part B premium for new members will be $115.40 per month. Those who make more than $85,000 per year have to pay more than this standard premium.

Benefits

• Part B Medicare has benefits for preventive and medically necessary services. Cancer, HIV and cardiovascular screenings, flu shots, smoking cessation programs and an annual physical are all covered under Part B. However, it does not have benefits for certain other services. For example, neither part of original Medicare has benefits for vision, dental or prescription drugs. Part B also does not have benefits for custodial care in any kind of nursing home or skilled nursing facility, most vaccinations, hearing aids and more than one routine checkup per year.

Enrollment

• Enrolling in Part B can be confusing. Some people who are eligible for it are automatically enrolled, while others are not. If you already get Social Security benefits or benefits from the Railroad Retirement Board, you will typically be enrolled in Part B automatically when you turn 65. If you don't want Part B, you will have to take the initiative to opt out yourself, by following the instructions on your Medicare card. However, if you are not already receiving these benefits, you will have to enroll yourself when you become eligible at age 65. If you somehow miss your enrollment period, you will have to pay a late fee of 10 percent of your monthly premium when and if you do decide to join.

Deductibles and Copays

• Even though you pay monthly premiums for Part B, you will also be responsible for meeting deductibles and copayments for services. In 2010, the annual deductible for Part B was $162 per person. Once the yearly deductible is met, users typically pay 20 percent of the approved amount for services. Home health and clinical laboratory services are free, but the copay for mental health services is 45 percent. If you get Part B through a private Medicare Advantage plan, your annual deductible and copays may be different.