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Top 5 Medicare Mistakes You Should Avoid

By Jagger Esch October 26, 2022 Health and Fitness

It can be easy to make mistakes when it comes to Medicare. This is because our health is often overlooked or pushed to the bottom of our seemingly never-ending to-do lists. Thus, we do not allow ourselves the proper amount of time to dedicate to learning how Medicare works and what mistakes we should avoid.

However, when it comes to Medicare enrollment, you may want to think twice about skipping steps or enrolling at the last minute.

A Medicare mistake can become a costly burden many do not anticipate and are unprepared for. Worst case scenario – you could end up with no coverage or a penalty you are stuck paying for the rest of your life. We do not want this to happen to you.

So, we have compiled a list of the top 5 Medicare mistakes you should avoid if you want to have a worry-free future with Medicare.

Missing Vital Medicare Enrollment Periods

Enrolling in Medicare comes down to understanding when you can and cannot apply for coverage. You can only enroll in Medicare during specific enrollment periods, and not everyone is eligible for each enrollment period. So, to enroll in coverage, you must know when you qualify.

When you become eligible to enroll in Medicare, you have an Initial Enrollment Period. This window allows you to enroll in Original Medicare (Medicare Part A and Medicare Part B). Once you have registered in Original Medicare, you become eligible to enroll in Medicare Advantage (Part C) or a Medicare Supplement plan. However, you must choose between the two plan types as you cannot enroll in both simultaneously.

Suppose you keep your Original Medicare or enroll in a Medicare Supplement plan. In that case, you can enroll in a Medicare Part D plan to provide you with prescription drug coverage. Remember, many Medicare Advantage plans offer drug coverage, so if you enroll in Medicare Advantage, you are not permitted to enroll in Medicare Part D.

If you miss your Initial Enrollment Period, there are additional enrollment periods for you to utilize throughout the year. Other enrollment periods include:

  • General Enrollment Period
  • Annual Enrollment Period
  • Medicare Advantage Open Enrollment Period
  • Special Enrollment Period

As you can see, Medicare enrollment works as a chain reaction. Once you enroll in one part, you may enroll in the next, and so on. Thus, missing one step in the enrollment process may halt future Medicare enrollment. Plus, if you delay Medicare benefits without creditable coverage, you may incur a late-enrollment penalty that can increase your costs in the future.

Ignoring Your Plans Annual Notice of Change Letter

Each September, your Medicare Part D and Medicare Advantage plan providers will send you an Annual Notice of Change letter containing all the changes your plan will undergo for the upcoming year.

This letter is not one to be thrown out with the junk mail pile. It is essential to read and understand this letter thoroughly as it may contain vital changes that could impact your coverage. If there are changes in your plan that do not align with your healthcare needs or budget, you will want to review and enroll in a new plan during the Annual Enrollment Period.

Enrolling in a Medicare Advantage Plan That Does Not Cover Your Doctors

Enrolling in a Medicare Advantage plan can sometimes be a gamble if the plan involves networks. A doctor can leave or join a plan’s network at any time. So, if your doctor accepts your plan when you first enroll, there is a chance they may not take your plan in the future, and you would be forced to pay higher costs for care or find a new doctor who accepts your Medicare Advantage plan.

To avoid this, it is essential to understand your Medicare Advantage plans network or enroll in a Medicare Supplement plan. Medicare Supplement plans are accepted by any physician who accepts Original Medicare, regardless of your plan’s carrier. This may be the best option for those with multiple doctors or who travel often.

Not Educating Yourself on the Differences Between Medicare Advantage and Medicare Supplement Plans

Contrary to what you may think, Medicare Supplement and Medicare Advantage plans are not the same. Many seniors on Medicare believe that the two plan names can be used interchangeably. However, that could not be further from the truth. Medicare Supplement and Medicare Advantage plans are two plan types with separate rules.

Medicare Supplement plans are secondary coverage that pays after Original Medicare. Thus, if Original Medicare does not pay, neither will your Medicare Supplement plan. Also, these plans have no network, meaning you can visit any doctor who accepts Original Medicare, and you will not be turned away based on your Supplemental insurance carrier.

On the other hand, Medicare Advantage plans pay in place of Original Medicare. These plans combine Original Medicare benefits with additional coverage to create an all-in-one source of coverage. However, these plans tend to have high out-of-pocket costs, more restrictions, and often require a network of doctors. This allows for more restrictive coverage when compared to a Medicare Supplement plan.

It is hard to determine which plan type is best for you as everyone is different. However, it is essential to compare all the plans available in your area to ensure you receive the best coverage possible.

Not Enrolling in a Separate Medicare Part D Plan with Original Medicare or Medicare Supplement

If you enroll in Original Medicare or a Medicare Supplement plan, you may notice a large hole in your coverage. Neither cover prescription drug benefits.

This is where Medicare Part D comes in. Medicare Part D helps cover some of the cost of prescription drugs. While it is not mandatory coverage, you may be required to pay the penalty if you do not enroll in Medicare Part D.

The Medicare Part D penalty is accrued if you delay Medicare Part D coverage without creditable drug coverage in place. Once you enroll in Medicare part D, you will be responsible for the penalty on top of your chosen plan’s premium for as long as you are enrolled in Medicare. The Part D penalty never goes away.

To avoid this additional cost, it is important to enroll in Medicare Part D coverage as soon as you become eligible.

How to Become Educated on Medicare Do’s and Don’ts

As you can see, Medicare can be confusing, and it can become easy to make a mistake that could cost you thousands of dollars or a lifetime of penalties. To avoid these mistakes, the best thing you can do is to educate yourself on all parts of Medicare.

Medicare education is essential as you become eligible for the federal healthcare program. Take advantage of free online seminars, speak with a licensed agent, and take the time to read your Medicare & You book, provided free of charge by CMS. By understanding your coverage, you become more likely to have success with your Medicare benefits in the future.

Let’s Have a Conversation:

Have you ever received an Annual Notice of Change letter? Do you have a Medicare Advantage or Medicare Supplement plan? How long have you been on Original Medicare? Have you ever made one of these Medicare mistakes? Let us know! We want to hear about your experiences with Medicare!

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Rebecca Alexander

Medicare Supplement plans are secondary coverage that pays after Original Medicare. Thus, if Original Medicare does not pay, neither will your Medicare Supplement plan. isnt this a contradiction? isnt the supplement medicare designed to pick up where original medicare leaves off?

Irene Bushell

The frequent Medicare Advantage commercials on TV are very enticing, yet misleading. Understanding this program versus a Medicare Supplement is essential. Read the fine print at the bottom of the screen ,and beware.

Pat Szczepanski

I still work but will be 65 in March -2023 so confused as to what to sign up for the 3 months prior to my birthday? I have health insurance and dental and vision, prescription, all right now through my employer!

Chris Darnall

You should speak to your HR department’s benefits manager before you hit 65 to find out what you need to do if you aren’t retiring as the rules are a bit different depending on how large a company you work at and what type of insurance you and your spouse have. I find the Medicare website confusing. https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/working-past-65

Pat Szczepanski

Thanks!!

Barbara Tuzzeo

When I turned 65 I asked my employer if they would set me up on Medicare original & whatever recommended supplemental. They did it & chose AARP United Healthcare as my supplemental. The company paid for both. After I retired, then the original Medicare was deducted from my SS check & I took over payments to United healthcare. It is all a bit expensive each month. However, I am cautious to only use docs that take Medicare and so far have not had to pay except for eye exams. Luckily my hearing is great. I travel some & it is important that I have insurance in every state, not just NJ. So for me, this was a great solution.

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The Author

Jagger Esch is a Medicare expert and the founder, president, and CEO of MedicareFAQ. He has been working in the Medicare space for over 10 years. Jagger has a passion for sharing his expertise on Medicare to beneficiaries so they can be better prepared for health care costs after retirement. His YouTube channel features various videos that help Medicare beneficiaries discover all their options.

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