Top 5 Medicare Mistakes

Top 5 Medicare Mistakes!

August 06, 20243 min read
Don’t make these common Medicare enrollment mistakes!

1. Failing to Enroll in Part B at the Right Time

Enroll into Parts A and B, 3 months before your birth month or 3 months after your 65th birthday month. If you or your spouse have employer group coverage with 20 employees or more, you can wait until you retire or lose group coverage. You are REQUIRED to enroll into Parts A and B if your employer group coverage employs less than 20 employees.

Failure to enroll at the required time will result in a 10% penalty for every year you delay enrollment. This penalty would be imposed for the rest of your life.

2. Failure to Analyze Your Prescription Drug Coverage

There are over 100 plans in Pinellas and Hillsborough counties with differing coverage on your prescriptions – it is important to know the most cost-effective way to cover your Rx.

3. Failure to Know the Difference Between Medicare Advantage Prescription Drug Plans (MAPD) and Medicare Supplements, aka, Medigap

Tampa Bay area Medicare Advantage Plans generally have $0 monthly premiums, no deductibles and require copays. All MAPD plans have service areas and network components: HMOs require a referral from a Primary Care Physician to visit most specialists. Many HMOs offer an incentive to enroll in the form of a Rebate or Buy down applied to your Part B premium lowering your out of pocket costs (up to $144/mo) PPOs do not require referrals and have the extra benefit of allowing out-of-network access to providers.

MAPD plans may also have additional benefits such as dental, hearing aids, vision/eyeglasses, gym memberships, and prescription drug coverage, etc.-not available with Supplements/Medigap. (These benefits seem to get more generous/cost effective every year)

Original Medicare with a Supplement or Medigap plan and a Prescription Drug Plan allows you freedom to choose any doctor that accepts assignment for Medicare. There is no network of providers/physicians. The service area is the entire US. The most comprehensive Supplement Plan for those born in 1955 and later is Plan G, which pays 100% for most of your medical care for only a $198 deductible with no copays or co-insurance.

4. Failure to Evaluate Your Employer Group Health Plan Options

Comparing your Employer Group Plan (EGP) to a Medicare Plan is critical. You may prefer your EGP costs and provider access, or you may be able to enroll into a Medicare plan that could offer a more cost effective alternative and may offer superior deductibles, coverage, or benefits.

5. Selecting a Medicare Plan Based on Subjective Reviews or False info

Everyone is unique. Choosing a plan your family member or neighbor owns is not making an informed decision. If you enroll because of an advertisement, doctor’s office advice, etc. it could be a mistake and cost you as a result.

Not all Medicare agents are the same. Many agents are only contracted with one company which may not be the right product for you. Do Not Take Advice from Agents That Only Work with One Insurance Company. Make sure you are dealing with a licensed Insurance Broker that carries multiple insurance companies and specializes in Medicare Insurance. Brokers do not have a vested interest in which MAPD carrier or plan you may choose. More expensive Medigap plans pay agents a higher commission. Make sure you are not overpaying for a Medigap G plan that works the same as lower cost Medigap G plan.

Be selective with those whom you conduct business. Be cautious of agents that use superlatives such as “better” or “best” as these are subjective terms. Make sure they are looking out for you before you make decisions that could affect you financially for the rest of your life.

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