7 Most Common Medicare Mistakes

Medicare is an incredibly complicated system that changes periodically, and there are now more options and complications than ever.  If you’re unclear on the various Medicare options, you may end up choosing one that doesn’t provide what you need. You can sidestep this mistake if you familiarize yourself with the different kinds of coverage.  The "Medicare & You" Handbook is a good place to start. Of course, at the Medicare Help Center, our team of Volunteer, Certified Medicare Advisors are available to provide the education, assistance, and guidance you need and deserve.

Although Medicare coverage typically starts when you turn 65, you have an opportunity to enroll in both Medicare and a Medicare plan option before your 65th birthday. Your Initial Enrollment Period (IEP) begins three months prior to the month of your 65th birthday and lasts three months after it. For example, if your birthday is in July, your IEP starts in April and ends in October. Enrolling before your birthday can help protect you from late enrollment penalties that boost premiums. 

No matter what type of Medicare plan option you choose, you aren't married to it forever.  You have an opportunity to change or renew coverage every year during the annual Open Enrollment Period which runs from October 15 to December 7. Auto renewal may be the easiest option, but it's not always the best option. Plan costs and coverage details can change from year to year.  Neglecting to review the details of your Medicare coverage is the most common mistake people make. People often miss the opportunity to have significant annual cost savings by simply not doing a plan review.  With the Medicare Help Center, a plan review is easy and it's FREE!

Certain aspects of your care and finances can affect your Medicare coverage, including:

• How Medicare coordinates with employer-sponsored health insurance. 
• Whether your primary care physician or specialist(s) are in a plan’s network.
• Whether there are enough providers in your area. 
• Do you need more Dental or Vision coverage in the upcoming year?

When choosing a plan, pay attention to not just the premium, but all the potential out-of-pocket costs. Most plans should offer a summary of these costs called a Summary of Benefits. You can also consult Medicare's plan comparison tool or a Certified Medicare Advisor in your area.

Furthermore, you can save a lot of money by optimizing deductibles. For example, if you have a year where you hit your deductible and maximum out-of-pocket [expenses], get everything else done that needs to be done. The care you receive once your maximum is reached is essentially free care at that point. Also, stock up on any medications after you've reached the maximum on your Part D portion as well. 

Prescription drug coverage under Part D and Medicare Advantage plans can be crucial to ease the bite of medication costs. Verify that your medications are on the plan’s list of approved medications (called a formulary) at the dosage and frequency you need. Your pharmacist can give you this information. Then check the plan’s prior authorization requirements, its copays for generic and brand drugs and any additional requirements. Also make sure its network includes your preferred pharmacy.

You may qualify for assistance with some Medicare premiums. For instance, Medicare Savings Programs help pay monthly premiums for Part A and Part B. You may also be eligible for:

• State Pharmaceutical Assistance Program. 
• Extra Help, administered by the Social Security Administration, reduces the burden of premiums, deductibles, coinsurance and other costs for people with limited financial resources. Determine your eligibility online or by calling the SSA at 800-772-1213 (TTY: 800-325-0778).