Medicare’s annual open enrollment periods are now done and we can all breathe a sigh of relief!  Hopefully, the TV commercials will take a break too.  At least until the Fall, that is…  

Here are some pitfalls that have happened to folks I have spoken with over the years.  I share them with you in hopes they don’t happen to you!

– Speaking of TV commercials – don’t believe everything you see on TV.  These commercials regarding Medicare plans can be VERY misleading.  The commercials tend to promote the better aspects of the plan, not the limiting aspects – such as a lack of primary care doctors in your area, or that the plan’s contracted doctors are out-of-network for your Assisted Living Facility.  Do you research first!

– Enrollment over the phone – another enrollment option to be weary of.  I just spoke with a gentleman that changed his plan over the phone.  He called me in a panic as he didn’t even remember what insurance company he had changed to.  Sadly, he didn’t have an election period to change back to his prior plan, and is now stuck until the Fall open enrollment.  Did you know it’s against Medicare guidelines for an agent or insurance company to make an unsolicited phone call to you?  It’s NOT rude to hang up the phone when you never gave permission for them to call you in the first place.  UPDATE:  the daughter was able to contact Medicare, lodge a complaint against the telesales agent, and get her father back on his prior plan.  

– Going without creditable drug coverage – Once you are in the Medicare system, you will want to choose a prescription drug plan.  Even though it’s “optional”, if you don’t enroll in a plan, you may be assessed a penalty at a later date when you do enroll.  Many people are financially blindsided by this.

– Going without Medicare after age 65 or upon later retirement – Someone who is enjoying very good health may not see the need to sign up for Medicare Part B (which is for your outpatient benefits) because it has a monthly premium.  However, should you need to enroll later in life, you may be assessed a penalty by Medicare.  I have also had clients that lived overseas and missed the enrollment period.  They had to pay the penalty!

– Not reviewing the plan network – Most Advantage plans have a network of doctors & hospitals you need to choose from.  I have had clients enroll in a plan on their own (over the phone, on the internet, or through another agent) that didn’t verify if their doctors were participating in the plan’s network of contracted doctors.  It was a shock to be told by the doctor’s office that their plan was not accepted.  Always verify!

– Services not covered – Not all services are covered by Medicare.  Did you know that many preventive services are performed only periodically and not necessarily every year?  Typically, a colonoscopy is covered only once every 10 years.  Read your plan benefits or the Medicare & You Handbook put out by Medicare each year.  

– Enrollment Periods – don’t miss your enrollment periods!  You are generally good when turning 65 or retiring, as well as each Fall.  These are times you can enroll or disenroll from plans.  But during other times of the year you may have to keep your plan and wait for the next enrollment period.

These are just a few examples of pitfalls that can trip you up on your journey through Medicare.  Educate yourself so it doesn’t happen to you.  Read the Medicare & You Handbook, your plan documents, or talk to a knowledgeable agent.  It’ll be worth the time.  Kathy Thousand, licensed & certified Medicare insurance plan agent in FL, NC & NY.