Mistakes to avoid when enrolling for Medicare

Elder Law
January 14, 2022

Mistakes to avoid when enrolling for Medicare

Medicare is a complicated system that has several plans, parts, and additional layers of health insurance coverage options. There is a reason why there are agents that are available at no cost to help retirees navigate securing insurance.

Some Medicare errors occur because people lack the right information or fail to notice something important in their coverage. By avoiding these common mistakes, you'll be able to get the care you need without having any major issues.

Even if you haven't enrolled in Medicare yet, keep these mistakes in mind so you don't fall behind when it comes time for enrollment. You're better off preventing problems than trying to fix them after.

During Enrollment

If you're already enrolled, you can avoid wasting time and energy by figuring out which one(s) of these common enrollment errors you've made.

Getting Full Prescription Plan Coverage

Assuming that the best Medicare plan for you is the same plan your spouse has. If you're taking any medications for health conditions, you might find that they aren't the same as your spouse's needs. Your spouse may have a plan that is better suited for their medical prescription needs, but not necessarily for your list of pharmaceuticals.

Determine which medications you regularly use so you know exactly where they fall under the insurance plan’s coverage, and then select a plan that does cover the costs for that specific set of medications.  Also, make sure to determine your out-of-pocket expenses separately for yourself and your spouse. Ensure that you’re both on the best plan for your individual prescription drug needs.

Working 40 Quarters to Qualify for Free Part A Coverage

Assuming you haven’t worked enough to qualify for Medicare.

If someone works and pays taxes for 40 quarters (or 10 years) during his/her lifetime, he/she may qualify for free Medicare Part A coverage. And it is only necessary to work for 40 quarters, or 10 years, in order to avoid paying the dreaded Part A premiums.

The social security administration collects the medicare tax on all working citizens and then funds the medicare part A premiums for all eligible senior citizens, and qualifying disabled persons. It is certain that if you have worked for most of your adult life you will have amassed the necessary quarters to receive this benefit. 

Part A covers hospital expenses. Be certain that you don’t qualify instead of making assumptions and avoid feeling uncertain about your insurance coverage. 

Changing your Plan Outside of Open Enrollment

Believing that open enrollment is the only time you can make a change.

There are qualifying circumstances that will allow you to change your plan outside of the usual October 15th through December 7th window. There are enrollment periods known as "Special Enrollment Periods" that are designed for people who have undergone an unusual circumstance, that would cause Insurance coverage to be reevaluated and changed. 

Circumstances such as: If you have recently moved and need to change your plan because you don't have access to the same physicians or specialists; this may require you to change your plan and is considered a special and qualifying circumstance to change your insurance. 

Another occasion when you can enroll in a new plan includes being dropped from your current plan due to changing employers or just simply retiring.

Forgetting When you Become Eligible

Not realizing that you can sign up to be covered by Medicare when you reach age 65, and qualify as early as three (3) months prior to turning 65 years old. If you do not enroll during the first stages of your qualification period, you may be subject to fines. 

Your premiums might increase by 10 percent per year if you don't enroll during the initial qualifying open enrollment period. You usually have to pay this penalty every single month until you stop paying using your part B plan. If you don't get Part B coverage within three months after your initial application for Medicare benefits, then your premiums will increase.

If you’re not receiving social security benefits, you’ll have to sign up for Medicare manually. It’s possible to sign up online. If you are receiving social security benefits, you’re automatically enrolled in Medicare. 

Paying More because you Earn More

Paying slightly more than usual for insurance because you're making slightly more money.

If you earn more than $85,500 annually, your insurance premium rates could go up by hundreds of dollars for the year. If you’ve reached the maximum income level for the year, making some minor changes may be worth considering.

You can speak with someone at Elder Needs Law, to help you plan financially for this circumstance. 

Having a Health Savings Accounts

Combining a Health Savings Account (HSA) and Medicare Part A cannot be done, both at once. After turning 65, you may be able to contribute to an HSA if you don't already participate in one. However, you won't be eligible for Medicare benefits until then. Decide whether using an HSA is more important for your medical needs than opting in for Medicare Part A (that is usually already covered with SSA benefits.)

Not Consulting a Licensed Medicare Agent

Not seeking out expert advice. You don't want to time later, trying to reconfigure your life and corresponding health care because you picked the wrong plan. It’s always best to get professional help when dealing with something like Medicare.

You may be able to get help from people who've been through similar circumstances when making decisions regarding Medicare coverage. However, because your situation is different than theirs, their advice won't necessarily be helpful. Your friend’s advice will be based on their own experiences. Find an expert who has experience working with these topics.

Not Signing up While Still Employed

Not signing up for an account because you're still employed.

If your employer does not have an adequate medical benefits package, then it might be worth considering enrolling in Medicare at age 65. However, if your employer does offer any kind of healthcare benefit beyond basic insurance, then you probably won't get anything out of joining Medicare.

Keeping the Same Healthcare Providers

If your health care provider is going to remain part of your Medicare Advantage Plan, you need to make sure that your plan is accepted at their offices and vice versa.

Advantage Plans Require you to have Hospital And Healthcare Providers also accept the medicare - Medigap insurance policy. If not, you'll end up paying more for health care costs.

Even if you're covered by insurance, you may not get 100% reimbursement for an unexpected health issue. Find a plan that includes your physician or find another one.

Avoiding these common Medicare mistakes could help you get the best insurance deal for your needs. To get the most out of your insurance policy, review your existing coverage at least once every year.