Medicare covers a vast bulk of your health care expenses throughout the Medicare-covered years of your lifetime. But Medicare’s rules can be a bit confusing, leading to many mistakes if you aren’t cautious. If you do not make the right choices to fill in the gaps, you could end up with some high premiums and high out-of-pocket costs Even worse, if you miss deadlines, delay your enrollment, or pick the wrong plans, you could miss out on valuable benefits from Medicare, and may be liable for penalties. These can all prove to be very costly Medicare mistakes. Here are some of the worst Medicare mistakes to avoid.
Not Signing Up for Medicare at the Appropriate Time
Timing is everything. It is especially important when it comes to enrolling in Medicare. As you approach the age of 65, you’ll want to enroll during your initial enrollment period (IEP). This seven-month time period goes from three months before the month you turn 65, until three months after. If you do not sign up during your IEP, then you will need to enroll during the general enrollment period, but may have a penalty for not enrolling when you first became eligible. If you register during Medicare’s General Enrollment Period, which is from January 1 to March 31 of every year, your coverage won’t start until July. Keep in mind that because you enrolled later, your monthly premiums for Medicare Part B will likely cost you more.
This is important to know if an individual does NOT have an employer group health plan in place. The rules are different, though, if you have been covered through an employer group health plan. When an individual has an employer group health plan, they can delay their enrollment into Medicare until they lose that coverage because of retirement. Keep in mind that at 65 years old, it is a good idea to apply for Medicare Part A coverage. Even if you are working and have employer group health coverage, it is free coverage, and it can work alongside your current employer-sponsored healthcare coverage in the event of a Part A benefit type of medical claim.
You’ll get a chance to enroll in a Medicare Advantage or a Part D coverage during your IEP as well. In this period, it is a good idea to consider what options will fit you best as an individual. Choosing Original Medicare, a Medicare Supplement, and a Part D coverage, or obtaining a Medicare Advantage plan that includes Part D coverage, is an important decision during this period. This can be one of the most crucial decisions you will make about Medicare, as in considering these options, this is your only guaranteed issue time to obtain a Medicare Supplement coverage. You see, during the first six months, an individual turns 65 years old, a Medicare Supplement company is required to accept the individual that is applying, no matter their medical condition. After this period, the Medicare Supplement company can require medical underwriting guidelines, and refuse an application if they determine the underwriting requirements are not to their desired expectations.
The Annual Enrollment period is a time that a Medicare qualified individual can enroll or disenroll in a Medicare Advantage plan or a Part D prescription drug coverage. This period is from October 15 -December 7 of each year and the policy you apply for will begin January 1 of the upcoming calendar year. The coverage you choose during this period will typically require you to stay enrolled throughout the calendar year. This is unless there is a Special Enrollment Period that the individual might qualify for during the year, which would allow them to enroll in a different coverage.
this is one of the most common Medicare mistakes. So the best practice is to ensure you have all the information you need before your 65th birthday, as not to make a Medicare mistake and sign up for the parts of Medicare that you need during the correct enrollment periods.
Supposing your Medical Providers Will Always be Covered by Your Medicare Advantage Plan
If you get your coverage through some private, all-in-one Medicare Advantage plan, which includes both prescription drugs and medical expenses, you usually have to use the plan’s network of hospitals and doctors to get the lowest cost-sharing on your out of pocket costs. It is essential to make sure your hospitals, doctors, and other providers are covered every year. You can switch Medicare Advantage plans during their Annual Enrollment Period each year (October 15 to December 7). Contact your insurer to avoid this costly Medicare mistake, as a plan’s network can change.
Not Understanding the Out-Of-Pocket Costs
Although Medicare will pay for the bulk of the medical costs for its enrollees, you have to be prepared for some sustainable out-of-pocket costs. Each part of Medicare might have its own monthly premium. Most people have no premium for their Part A, which covers hospital services. You’ll be responsible for the Part B monthly premium, which typically comes out of your Social Security benefit payment (if you are collecting it). Before Medicare starts to pay for the cost of your care, you might have to pay a flat amount, otherwise known as a deductible. Part A and Part B in original Medicare have annual deductibles, co-insurance, and copays associated with obtaining medical care while using the program. Medicare Advantage and Part D prescription drug plans also have their own rules and can also include deductibles, co-insurance, and copays according to the regulations of each program. A Medicare Supplement also will have its own costs involved with your policy that may include premiums, deductibles, copays, and limits to services provided.
Keep these essential points in mind before obtaining your Medicare and secondary coverage. If you have any questions regarding common Medicare mistakes that people make or need help choosing the right plan for you as an individual, do not hesitate to reach out to Healthcare American!
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