When you sign up for Medicare, you have to make several important decisions, and the rules and choices
can be complicated. Here are 10 common mistakes that prospective Medicare enrollees make, and steps
you can take to avoid these problems. I will break down in the next few months the 10 Mistakes from an
AARP article.
- NOT FULLY COMPARING ORIGINAL MEDICARE WITH MEDICARE ADVANTAGE PLANS
If you’re eligible for Medicare, you have two options: original Medicare or a Medicare Advantage plan. The type of coverage you choose depends on factors such as your health care needs, the insurance your doctors accept, where you live, whether you travel often and your financial situation.
Original Medicare. This traditional Medicare program is offered directly through the federal government.
It consists of Part A, which covers hospital costs, and Part B, which covers doctor visits and other
outpatient services. Most doctors in the country accept this insurance.
To help pay for out-of-pocket costs, you can buy a Medigap policy, which has a separate monthly
premium. Original Medicare doesn’t include Part D prescription drug coverage, so you’ll need to buy a stand-alone Part D plan from a private insurer if you don’t have other drug coverage. Original Medicare doesn’t limit your annual out-of-pocket costs.
Medicare Advantage. This is a private insurance alternative to original Medicare. These plans provide
Part A, Part B and usually Part D benefits. They also may offer some benefits that original Medicare
doesn’t, such as dental or vision care.
Medicare Advantage plans generally have a provider network, like the health maintenance organization (HMOs) and preferred provider organizations (PPOs) offered in many workplaces. They may charge more or may not cover care for out-of-network doctors and hospitals, except in emergencies.
Some Medicare Advantage plans require a referral from a primary care physician before they will cover specialist care. The plans are required to limit the amount of money you pay in copayments, deductibles and other out-of-pocket expenses, not counting premiums, each year. In 2024, the maximum out-of-pocket limit is $8,850 for care in your plan’s network, excluding prescription drug cost sharing, but some plans have lower caps.
You are not allowed to have a Medicare Advantage plan and a Medigap policy at the same time.
2. NOT SIGNING UP FOR MEDICARE AT THE RIGHT TIME
You can sign up for Medicare only at certain times. Your initial enrollment period starts three months
before the month you turn 65 and ends three months afterward.
If you don’t sign up during that seven-month window, you’ll have another chance to enroll during
Medicare’s general enrollment period, which runs from Jan. 1 to March 31 each year. Your coverage will
begin the month after you sign up during the general enrollment period, and you may have to pay higher
Medicare premiums for the rest of your life.
The late enrollment penalty can add 10 percent to your monthly Part B premium for every 12 months you
delay. But you may be able to postpone signing up for Medicare without a late enrollment penalty if you or
your spouse are still working and you have health insurance based on that job.
3. BEING CONFUSED ABOUT YOUR OPTIONS IF YOU WORK PAST AGE 65
Even though you can sign up for Medicare at age 65, some people who plan to keep working and receive
health insurance through their jobs decide to wait until later so they don’t have to pay premiums for both
their employer’s coverage and Part B.
Signing up for Part A is a good idea for most 65-year-olds. The premiums are free if you or your spouse
have worked long enough to be eligible for Social Security or Railroad Retirement Board benefits — even if you haven’t filed for them yet. For Part B, you won’t face a late enrollment penalty as long as you sign up
before or within eight months of losing your job-based health care coverage. That is what Medicare
considers a special enrollment period.
Many people don’t realize that this waiver of penalties applies only to job-based coverage from a current
employer, not retiree health insurance or COBRA, which allows most people to stay on their company’s
insurance plan for up to 18 months after they leave their job. Unless you or your spouse are still working
and are covered through a current employer, it’s important to sign up for Medicare during your seven-
month initial enrollment period, or you may face a late enrollment penalty and gaps in coverage later on.
Feel free to reach out to me if you have any questions or need help transitioning to a new plan. I will
continue in the next few months the remaining Medicare Mistakes.
[email protected] Text: 714-930-7165 Direct: 904-648-6488 www.AskCarolB.com FL License #:
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