1. Signing up too early or too late for Medicare – If you are aging into Medicare, your Initial Enrollment Period is based on your 65th birthday. To avoid long-term penalties, make sure you know what you have to choose – and by when. If you or your spouse are still working when you turn 65 and your insurance meets certain requirements it may make sense for you to delay enrollment in Parts A, B, and D (saving you the Part B monthly premium). Always check with your Human Resources Department!
2. Not understanding the difference between a Medicare Supplement and a Medicare Advantage policy – If you are new to Medicare, you have a fundamental choice to make: keep Original Medicare or choose an Advantage Plan. Original Medicare (also known as Parts A and B) is a fee-for-service program (which does not cover 100% of your medical expenses). Most consumers supplement this government benefit with a Medicare Supplement (also called Medigap) policy to cover some or all of the expenses Medicare does not cover, as well as a Part D plan for prescription drugs. If you choose a Medicare Supplement policy, you will pay an additional monthly premium. You won’t need prior authorization or referrals to see specialists, and can choose any doctors that accept Medicare patients. 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 employer plans. They are sold through approved, licensed insurance companies and many plans have $0 or low monthly premiums, and you pay copays based on the plan’s schedule of benefits. Most include prescription drug coverage as well as services that Medicare does not, such a health/wellness programs, vision and hearing care. However, the plans may require you to choose your doctors and hospitals from a network and some require prior authorization for specialty services. During open enrollment, you have the option of changing from one type of plan to another if your needs have changed.
3. Guessing when picking specific plans – It can be very difficult and time-consuming to compare all of the plans that are available to you. Many people try to do their homework, get frustrated and then “give up and guess.” Sound familiar? Choosing a Medicare plan is too important to leave to guesswork. Take the time to review your health insurance needs before your first – and every subsequent – open enrollment period, which is from October 15th to December 7th each year.
4. Not applying for financial assistance – Millions of older adults are eligible for billions of dollars in programs that can help them pay for their prescriptions, health insurance premiums, and deductibles and copays. If your income in retirement is modest, you should find out if you qualify for assistance. We can help see if you’re eligible and apply for Extra Help and Medicare Savings Programs.
5. Not re-evaluating your coverage every year – Unfortunately, choosing health insurance is no longer a one-time 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 and change their Part D coverage. Make sure to confirm cost, copays, covered providers (doctors) and prescription drugs.
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. If you’re unsure about your choices, start with the Medicare QuickCheck on www.MyMedicareMatters.org to get a personalized report on your options and use that to start a conversation with a licensed insurance agent – that’s us! We are paid directly from the insurance carriers, so there’s never a fee to use our services. And because we are independent agents offering a wide selection of plans & companies, the choice is yours!
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(Portions of this column were borrowed from the My Medicare Matters, National Council on Aging)