Service Benefit Plan and Medicare Part B, Working Together For You

It’s comforting to know that your health insurance coverage is there for you when you need it most.  If you’re 65 or older and have Medicare Part B as your primary coverage (it pays first), you have even more peace of mind because we pay your Medicare Part B and the Service Benefit Plan deductibles and coinsurance amounts are waived on covered services.  That means you save money every time you receive covered services, especially when you use Preferred providers. 

What is Medicare Part B?

Medicare Part B is health insurance designed primarily for people 65 or older, although it is also available to people with certain disabilities and health conditions. In general, it helps cover doctors’ services, hospital outpatient care, home health care and some preventive services.  Medicare Part B members pay coinsurance and deductibles for many of the covered services.  There is also a separate monthly premium for Medicare Part B. 

Savings That Make an Impact

Josephine, a federal retiree in Tucson, Arizona, knows firsthand how valuable having both Medicare Part B and the Service Benefit Plan coverage can be in keeping out-of-pocket expenses to a minimum.  Josephine says, "I love to walk and hike, but it can take a real toll on my joints.  When arthritis flared up in my knee and I needed outpatient physical therapy, I was pleasantly surprised to find that my copayments were waived since my Medicare Part B and Service Benefit Plan Standard Option coverage worked together.  That saved me $20 at every visit.  When you’re living on a fixed income, savings like this really mean a lot."

Here are some other ways you save when your Service Benefit Plan coverage and Medicare Part B work together to pay for covered services.  

Be sure to use Preferred providers to receive the highest level of benefits. Your out-of-pocket costs will be higher when you use Non-Preferred providers. For Basic Option members, Service Benefit Plan benefits are only available for care provided by a Preferred network provider except in certain situations such as emergency care.

Ready to sign up for Medicare Part B?

Most people become eligible for Medicare when they turn 65. Most people enroll in Medicare Part A when they first become eligible because they do not pay a premium for Part A. If you begin to collect Social Security Retirement benefits you must enroll in Part A.

Medicare Part B is optional. You can choose to enroll at the same time you enroll in Part A, or delay enrollment. Everyone pays a premium for Part B. Many people with other health insurance from employment choose to delay Part B enrollment to save the premium cost. And, as long as you have “current employment health insurance” from your employer or that of your spouse, you can delay Medicare enrollment without paying a penalty for delayed enrollment. Once your current employment health insurance ends, be sure to sign up for Part B as soon as possible to avoid paying a penalty in the form of a higher premium.

If you decide to enroll when you turn 65, your initial enrollment period starts 3 months before the month you turn 65, and ends 3 months after the month you turn 65. Your Medicare coverage will start the month you turn 65 or later if you enroll after your 65^th birthday.

Contact Medicare at www.medicare.gov or 1-800-633-4227 if you have questions about your Medicare eligibility and premium amounts.

 If you are eligible for Medicare you might consider enrollment in Part B even with Service Benefit Plan coverage. If you have high out of pocket costs from Medicare deductibles, copayments and coinsurance, you can save money and have peace of mind knowing that your out of pocket costs are paid.

January 2011. Vanessa Chandler, King Consulting, Inc. Resources: 2011 Blue Cross and Blue Shield Service Benefit Plan brochure.

Page last updated: March 27, 2012