Medicare mistakes can cost you money and coverage, so we’ve broken down the most common Medicare errors and outlined solutions.
Millions of older Americans are covered by Medicare, but it’s a complicated program that needs seniors to do their homework both when they first enroll and each year during the renewal process. This task can be so intimidating that you may want to put it off for as long as possible. But putting things off might be a costly mistake.
Medicare errors
Not registering on time
With Medicare, time is of the essence. Three months prior to your 65th birthday, the month you turn 65, and the three months following your birth month make up the seven-month window for initial Medicare enrollment. If you fail to enroll for Medicare Part A and/or Part B, together known as original Medicare, during the initial enrollment period, you’ll get another chance during the fall open enrollment period, which runs from October 15 to December 7 each year.
The Problem: According to Dr. Elizabeth Landsverk, a geriatrician in the San Francisco region, “there’s a financial penalty for missing that window that increases the more you wait.”
The Solution: As you get closer to your 65th birthday, pay close attention to any mailings you receive from the Centers for Medicare & Medicaid Services and any health insurance plans you now have.
Medicare errors
Failure to Register During the Special Enrollment Timeframe
The special enrollment period, which begins when certain conditions are met, is equally as important as the initial registration period. These include:
- You either retire or lose your spouse’s employer-sponsored health insurance beyond the age of 65.
- You relocate to an area beyond the service area of your existing plan, or your move opens you new plan alternatives.
- You’ve recently been released from prison or relocated out of an institution, like a skilled care facility.
- Prior to losing your Medicaid eligibility, you were eligible for both Medicare and Medicaid.
The Problem: The issue is that you may have to pay a penalty if you miss these brief windows of opportunity, which can be expensive and may restrict your future options for receiving the care you require.
The Solution: Ensure that you know when enrollment is scheduled.
Medicare errors
Not Using Original Medicare to Access a Stand-Alone Medicare Part D Prescription Drug Plan
Medicare Part D, which covers prescription medications, is one of the many components that make up Medicare.
The Problem: You will be assessed a late enrollment penalty if you do not enroll in a Part D prescription drug plan and do not have other creditable prescription drug coverage for more than sixty-two days, such as a plan provided by the Veterans Administration or your employment. If you later choose to enroll in Part D prescription medication coverage, you will be penalized with increased rates for the duration of your Medicare coverage.
The Solution: The answer is to enroll in Medicare Part D coverage even if you don’t currently take any prescription medications.
Failure to Receive Supplemental Coverage on Schedule
Original Medicare has some big gaps in coverage that can be costly if they aren’t filled when you first enroll.
The Problem: “When first signing up for original Medicare Parts A and B, which leave you with significant coverage gaps, you generally have a six-month window to enroll in other forms of Medicare insurance that can help you fill those gaps,” explains Bob Rees, chief sales officer with eHealth Inc., a health insurance broker and online resource provider headquartered in Santa Clara, California.
The Solution: The answer is to choose extra plans or products that fit your requirements and guarantee that, in the event that your health deteriorates, you won’t have significant coverage gaps. Copayments, deductibles, and coinsurance are examples of out-of-pocket costs that original Medicare does not cover that can be partially covered by a Medicare supplemental insurance policy, also referred to as Medigap.
You must enroll in Medigap coverage during the Medigap initial enrollment period in the majority of states because there is no nationwide yearly open enrollment period for Medigap. Health plans may reject your application or raise your premiums if you have any health issues if you fail to enroll during this window.
Medicare errors
Not Knowing How Medicare Works With Your Existing Insurance
Finding out how your current health insurance and Medicare will operate together is crucial if you’re still employed when you turn 65. For instance, your job insurance is regarded as secondary, and Medicare may become your primary insurer based on the size of your employer.
The Problem: Medicare will only pay for services not covered by your private insurance plan. With a base premium of $174.70 per month for 2024 (which is expected to rise to $185 per month in 2025), you could be spending a lot for a Part B plan that you rarely use.
The Solution: Be sure you understand how any employer-sponsored health insurance plans you have work with Medicare. It’s critical to clarify when and how each plan will cover services and fees. Not knowing whether your employer’s coverage is primary or secondary can cost you a lot of money. Working with an adviser who can guide you on your selections and how your Medicare plan might work with existing insurance can help you avoid those headaches and expenses.
Medicare errors
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Disclaimer: The opinions and suggestions expressed in this article are solely those of the individual analysts. These are not the opinions of HNN. For more, please consult with your doctor
