6 Useful Tips to Avoid Medicare Mistakes

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Finding the right Medicare plan can be complex and stressful. With different options and policies to choose from, and a great deal of information to comprehend, many people make mistakes when choosing their policy. Medicare enrollment mistakes happen, and believe it or not, it can cost you a lot of time, effort, and money.

Ultimately, you end up paying too much for a plan that doesn’t cover what you need. For boomers who haven’t jumped on the Medicare bandwagon yet, that moment is likely coming. You must be enrolled in Medicare at age 65 and can actually sign up as early as three months before your 65th birthday, assuming you’re eligible for federal health insurance program. So before you cross the road to Medicare, take a look at the most important mistakes to avoid when signing up.

1. Signing up too early/too late for coverage

If you are in the road to Medicare, your Initial Enrollment Period (IEP) is based on your 65th birthday. To steer clear of long-term penalties, make sure you know what you have to choose—and by when. If you or your spouse is still working when you turn 65 and your insurance meets certain requirements, it may make sense for you to delay enrollment in Medicare Part A, Medicare Part B and Medicare Part D.

 

2. Confusion between Medicare Supplement and Medicare Advantage Policy

It’s imperative that you get off to a fresh start when signing up for Medicare, so you must know your choices–enroll in Original Medicare or opt into a Medicare Advantage plan. It’s vital that you’re aware of the pros and cons of both types of coverage.

Original Medicare (also known as Parts A & B) is a fee-for-service program. Most consumers supplement this government benefit with a private Medicare Supplement (also called Medigap) policy as well as a Medicare Part D plan for their prescription drugs. A Medicare supplement policy may cover some services that are not included under the standard Medicare Parts A and B as well as some out-of-pocket costs such as: co-insurance costs for care at skilled nursing facilities, the Part A deductible and foreign travel emergency care.

If you choose a Medicare Supplement policy, you will pay an additional monthly premium. You won’t need prior authorization to use specialists or to get second opinions. A Medicare Advantage Plan (Part C), on the other hand, takes the place of original Medicare Parts A and B. These plans work more like group insurance. They are sold through approved, licensed insurance companies and may have an additional monthly premium. Often, Medicare Advantage plans include prescription drug coverage as well as services that original Medicare does not such as health/wellness programs and vision care. However, a Medicare Advantage plan may also limit a person’s ability to use doctors and hospitals, and also require prior authorization to use specialty services. During open enrollment, you have the option of changing from one type of plan to another if your needs have changed

Information by The National Council on Aging (NCOA)

3. Don’t guess when picking your plan

It can be very tricky and time consuming to compare all of the plans that are offered to you. Many people try to gather as much info as they can, but get frustrated and guess on what plan they want to choose. Choosing a Medicare plan is imperative… so don’t just leave it to guesswork. Take your time and evaluate your health insurance needs before your first—and every following—enrollment period.

Think about:

  • Do you have health insurance from another source?
  • Do you have any chronic conditions?
  • Which doctors and hospitals do you use?
  • Which prescriptions do you need and what pharmacies do you get them from?

4. Not applying for assistance

Millions of older adults are eligible for millions of dollars in programs that can help them pay for their prescriptions and health insurance premiums, deductibles and coinsurance. If your income in retirement is modest, you should find out if you qualify for assistance. (The National Council on Aging (NCOA) NCOA also offers a free online BenefitsCheckUp where you can see if you’re eligible for certain assistance.

5. Not re-evaluating your coverage each year

Unfortunately, choosing health insurance is no longer a onetime decision for most Medicare beneficiaries. Insurance companies can make changes to policies every year. Just because your doctor and medications are covered this year doesn’t automatically mean they will be covered in the coming year. Research studies show that the average consumer could save $300 or more annually if they review their Part D coverage. Make sure to confirm cost, copays, coinsurance, covered providers, and prescription drugs.

Here are a few things to consider:

  • Has your health changed in the last year?
  • Is your current plan still meeting all of your health needs?
  • How much have you paid out-of-pocket in the last year—and for what?
  • How is your plan changing for the coming year? How will that affect your out-of-pocket costs?
  • Are there better options available to you now?

6. Not asking for help

You don’t have to do this on your own. You can get help from a trusted source that can help you think through your options and compare plans. From State Health Insurance Assistance Programs (SHIPs) to various organizations that support senior citizens, there are additional resources to help you make the right decisions when it comes to understanding your Medicare plan. You can also reach out to various Medicare beneficiaries at the Medicare World Facebook page, where several fans have shared feedback about various Medicare issues.

Additional Medicare information resources:

  • Visit www.Medicare.gov.
  • Call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, 24 hours a day, 7 days a week.
  • Call your local State Health Insurance Assistance Program (SHIP) to see if you qualify for any financial assistance
    • Medicaid: helps pay for health care costs not covered by Medicare for people and families with limited incomes. It may also offer extra benefits that Medicare doesn’t cover, but each state creates its own program, so contact your state office for more information.
    • Medicare Savings Program helps you pay your Parts A and B premiums, deductibles and coinsurance.
    • Program of All-Inclusive Care for the Elderly (PACE) combines medical, social and long-term care services for frail elderly people who live in the community, not a nursing home. It’s not available in all states.
    • Prescription drug premium assistance program helps pay for some or all of a person’s Medicare Part D premiums, deductibles, and copays or coinsurance.
    • Other programs may be available in your state.

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Medicare doesn’t cover everything. Luckily, those on Medicare can now start saving on out of pocket expenses like prescription drugs, dental, vision, hearing, and more. Over 1 million people have already received their free Medicare Plus Card.

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Medicare World Editorial Team
The Medicare World editorial team works diligently to make sure our stories are informative, unbiased, and of utmost relevance to our readers. Our team of researchers and writers presents the best and latest information on all things Medicare, including legislation, enrollment rules, changes in coverage and costs, and health information. We enjoy keeping our readers up-to-date and helping them navigate the often-complicated Medicare maze.

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