In most cases, when you turn age 65, you will automatically be enrolled in Medicare, the government-sponsored health insurance program. Medicare Part A covers major items such as hospitalization and requires no additional premium, as it is paid for through employee payroll taxes. Part B covers items such as outpatient care and doctor visits and requires an additional premium, currently $110.50 per month for new enrollees as of 2010. You are not required to take Part B, however, and there may be some situations where you may choose to decline it.
Other Coverage
Perhaps you are 65 or older and are still covered by an employer-sponsored health insurance policy, either from a current or former employer or from a spouse's coverage. In that case, you would be likely be paying for duplicate coverage if you signed up for Medicare Part B. However, if you are over 65, you can still enroll within eight months of the termination of your current health plan. Even if you did not have prior coverage, you can also enroll after age 65 between January 1st and March 31st of each year. However, you will be required to pay a penalty in addition to the premium.
Self-Insured
Your financial situation may be such that you may be able to afford to pay for such care as doctor visits and feel that paying the Part B premium would not be worth the expense. You may feel that you are in relatively good health and aren't concerned about possible medical expenses. In that case, you may decide to participate in Medicare Part A and decline Part B. You will have the coverage for major medical expenses like hospital stays but you won't be required to pay additional premiums.
Affordability
On the other hand, your income may be limited and you are having difficulty making ends meet on Social Security benefits and any other retirement income you may have. In this situation, you may need to make the difficult decision not to enroll in Medicare Part B. If so, you may want to consider looking into lower-priced supplemental plans for seniors. Most states have government programs that can assist in paying Part B premiums.
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