Medicare Part B: Can you afford NOT to have it?

Nearly half the questions health insurance hunters have involve or revolve around Medicare Part B. As in, do I need it? Can I afford it? What, if any, are the alternatives to Medicare Part B. What happens to the premium if I delay taking it? And by the way, what is it?

The short answer is that it depends. On your age, health, financial situation, etc.

And the clock is ticking. You have until close-of-business Monday to pick your 2018 health plan. Your current plan may be fine, maybe truly the best for you and yours. But you won’t know that for sure unless you shop around.

Walton Francis, editor of Consumers’ Checkbook Guide to Health Plans for Federal Employees, says many people could save $1,000 or more in premiums if they’d check out at least two other plans. Then compare them, their benefits, 2018 changes, networks (as in, is your doctor part of it?) and catastrophic limits for all three plans. He says it is possible to get free insurance in some of the consumer-driven (CD) or high-deductible (HD) plans.


There are some people (or couples) who definitely need it and should have it. There are other situations where they can do without. There are even times when a retiree can and should suspend (not quit) his or her Federal Employees Health Benefits Program coverage, and get Medicare Part B and a Medicare Advantage or wrap-around policy.

Many feds are also curious about, but confused by, the CD and HD plans. But Francis says they are great buys for many people and likens them to “an IRA on steroids.”

The most important thing to look for in a health plan is the limit-to-you. How much money you would have to pay, out of pocket, if you are hit with a serious illness, disease or accident next year. For a family of three, Checkbook says the lowest limit-to-you amount is in Kaiser’s high-option plan. But it can be as high as $17,510 in Aetna’s open-access high-option plan, and $19,980 in the SAMBA high-option plan. Big difference.

Make sure your doctor or doctors will be in the plan’s network in 2018. If not, you will either have to pay lots out-of-pocket or find yourself a new doctor. Again, it pays to shop around.

If you have last-minute questions, Walton Francis will be our guest today on our Your Turn radio show. It’s 10 a.m. to 11 a.m. on or in the D.C. area on 1500 am. If you have questions or comments, email them to me (before showtime) at

The show will be archived on our homepage, along with earlier columns about special features of the different health plans. So if you can’t listen today, you can check it out later or pass it along to a friend or coworkers. Two hours of comparison shopping could save you as much as $2,000 next year. That’s not a bad hourly rate.

Nearly Useless Factoid

By Jory Heckman

Sitka, Alaska, is the largest city by area in the United States.