Can I opt-out of Medicare Part B when I turn 65, later this year?

Tomw asked...

I will be 65 in December of this year. I currently use the VA for all my health care needs. I am not disabled. I am living on Social Security Income exclusively. How do I opt-out?

Expert Answer

If you get medical benefits through the VA, you may not need coverage from Medicare Part B (covering doctors bills and other outpatient care). Medicare Part B costs more than $100 per month for most people, and if you aren't going to use it, you might not want to enroll in it, and if you don't want Part B, you don't have to have it. By the way, there is no reason not to be enrolled in Medicare Part A, which covers inpatient hospital and short-term nursing home care, because you pay no monthly premium for Part A.

The question about whether to enroll in Medicare Part B depends on whether you are completely satisfied with the medical care and coverage you get from the VA. Many people who are eligible for coverage from both systems find that at some point they would prefer to get certain care from outside the VA system, or that the care they want is not available from the VA where and when they want or need it. In those cases, being enrolled in Medicare Part B would give you a wide choice of non-VA health care providers. On the other hand, if you live in an area that has extensive VA medical facilities and the care you are offered locally by the VA seems very broad -- and you're satisfied with it -- then you might choose to get your care exclusively from the VA and not pay for Medicare Part B just to have it as a back-up.

If you do not enroll in Medicare Part B when you turn 65, but later on you find that the VA system is not providing you with full or satisfactory care, you could then enroll in Part B. However, there are some negatives to this approach. First, you can only do this delayed enrollment in Medicare Part B during an "open enrollment" period in the first three months of each year, with coverage to begin July 1 of that year. In other words, you can't get Medicare Part B coverage immediately whenever a situation arises that you want care from outside the VA system. Also, if you delay enrollment, your monthly premium will be higher than the normal premium by 10% for each year than you were not enrolled.

Because you are already receiving Social Security benefits, you will be automatically enrolled in Medicare Part B when you turn 65. So, if you choose not to enroll, you must contact Social Security -- either through a local office or online at the social Security official web site -- to inform them of your choice not to be enrolled. You should do this several months before you turn 65.

To learn more about how Medicare and VA medical benefits work together, take a look at the Medicare online booklet Medicare and Other Health Benefits: Your Guide to Who Pays First[].