Should I Enroll in Medicare Part B?

One of the most popular questions we hear is: “Should I enroll in Medicare Part B?” It’s a great question—and one that doesn’t always have a straightforward answer. That’s because there are exceptions to almost every rule under Medicare. For every guideline out there (like you must enroll in Part B, or you must have Part D, or you’ll be penalized), there’s a twist. A condition. An exception.

That’s why working with someone local—someone who’s an independent agent who knows your market—is so important.

Let me repeat that: work with an independent agent. That means they’re not tied to any one insurance company. They’ll help you look at your situation and figure out what’s right for you. We say that a lot because it matters—a lot. Cookie-cutter answers don’t work when your health, income, and family situation are on the line.

First: What Other Coverage Do You Have?

Before anything else, we ask: what other coverage do you have available? It’s not just a formality. It’s the very first step in the Medicare decision tree. And your answer determines the rest of the path.

Here’s what counts as “other coverage”:

Employer group health coverage (either yours or your spouse’s)
VA benefits
TRICARE or CHAMPVA
Federal employee health benefits
Tribal health benefits
Group retiree coverage from a former employer

The key thing is whether that coverage is considered creditable by Medicare standards. If it is, you might not need to enroll in Part B right away—and you won’t be penalized for waiting.

But here’s a big catch: Marketplace plans (like those from Healthcare.gov) don’t count as creditable coverage. Neither does most state Medicaid coverage. If that’s your situation, the answer changes fast—you probably should enroll in Medicare Part B as soon as you’re eligible.

If You Have Other Creditable Coverage

Let’s say you do have other coverage—like your spouse’s insurance or TRICARE. Here’s what we need to look at next:

What’s your monthly premium?
What’s the deductible before the plan pays anything?
What are your typical co-pays for visits and prescriptions?
Are your doctors in or out of network?
Are there any others in your household (a spouse or dependent) also using that insurance? Would they lose coverage if you dropped it?

This is where a good health insurance agency in Green Bay WI comes in, especially when they’re an independent agent in Green Bay WI. They don’t just give you a generic yes or no. They walk you through all the benefits side-by-side of what you have now versus what Medicare could offer to you. It’s kind of like test driving two vehicles—you’ve got to know the gas mileage, the comfort level, the maintenance costs. We break all that down together with you.

And if it turns out that staying with your group coverage makes more sense for now, that’s totally fine. But if Medicare could offer you better benefits or save you money, we’ll show you how.

If You Don’t Have Other Coverage

If you’re reading this and thinking, “I don’t have any other insurance,” then the answer is usually very simple: yes, enroll in Medicare Part B. If you don’t, you risk a permanent penalty that gets added to your monthly premium for life.

There are only a very few exceptions around this rule. One is if you’re living outside the U.S. for an extended period. Another might be if you’re covered under a unique federal or international program. But these are pretty rare. If you think you might qualify, please, call us any time. We’ll help you figure it out.

I had a new client last month who moved back from living overseas for five years. He thought he would be able to just sign up like normal; But because he’d delayed Part B and didn’t have creditable coverage during that time, he was stuck with a late enrollment penalty. He had no idea about that. We don’t want that to happen to you.

What If I Delay my Part B?

Another big question: “If I delay Part B now, will I lose my chance to get a Medicare Supplement later?”

Great question. And no—you won’t lose your chance as long as you had creditable coverage in place when you delayed.

When you leave your employer coverage or other creditable insurance, you’ll get a Special Enrollment Period (SEP). That’s your personal window to enroll in Part B and also pick a Medicare Supplement or Advantage plan without facing penalties or medical underwriting.

The key is to have documentation showing you had creditable coverage the whole time. That’s something your independent agent can help you request and keep on file.

Why This All Matters

When we talk about Medicare Part B decisions, we’re really talking about timing. The timing of when you sign up affects what you’ll pay and what you’ll be allowed to enroll in later. It’s not always about now—it’s about setting yourself up for flexibility later.

An example that comes to mind, I had a client call me who was eligible for Medicare and still working full-time. Her job had great insurance and she didn’t need Medicare yet. But her husband, who was 67, was ready to retire and wasn’t sure what to do. After a thorough discovery discussion, we were able to confirm that her employer plan was considered credible coverage according to Medicare’s standards; We were able to delay Part B and save $185 per month without any issues. That kind of peace of mind is priceless.

Why Use an Independent Agent?

If you’re making a Medicare decision and not yet sure where to start, please—don’t do it alone! I personally love helping in those situations.

An independent insurance agent (like those at OnMedicare) isn’t tied to any one carrier. We’re licensed with multiple companies. That means we can compare all the options available in your zip code, help you weigh the pros and cons, and give you a personalized recommendation—not a cookie-cutter one.

We’ve seen it all. There are exceptions to almost every rule with Medicare. And just as many unique ways to save. Whether you’re retiring soon, already on Medicare, or just doing early research, we’ll meet you where you are.

Final Thoughts to wrap up

The question “Should I enroll in Part B?” seems simple. But behind that question are dozens of other variables—job status, coverage type, retirement goals, budget, prescriptions, providers.

There’s no one-size-fits-all answer. But there is a right answer for you.

At OnMedicare Insurance, we’ll help you find that answer. No pressure. No sales pitch. Just guidance based on facts and what fits your life best.