Avoid These 6 Common Medicare Mistakes

1. Sign up on Time

If you fail to enroll within your initial enrollment window, penalties will be assessed and you could potentially be without coverage for several months. It is also important to be aware that there is a delay between registration and initiation of benefits. The only people that are automatically enrolled in Medicare are those already receiving social security benefits.

2. Know that Medicare Does Not Cover Long Term Care

Not a chance. Medicare does not cover long-term care. Yes, skilled nursing facility and home care are included in original Medicare, but be aware benefits are based on what is defined as a “medical necessity” and require a 3 day stay in a hospital for payment. The definition of “medical necessity” is fine and narrow.

Too many assume that LTC is included and it’s not. This is just another thing to consider when selecting plans and budgeting for retirement. Remember that your retirement years are often the most costly especially when it comes to health care.

3. Don’t Forget about Part D

Part D is usually relatively inexpensive, but if you enroll late you will pay an additional penalty as long as you receive Part D coverage. The national base beneficiary premium may increase each year, so your penalty amount may also increase each year.

Some medications can really break the bank. You don’t want to be stuck paying out of pocket for these. You never know what tomorrow holds, so get your drug coverage when initially eligible and be prepared.The Majority of Beneficiaries purchase more insurance to cover the 20% Medicare does not pay.

If you chose to go with a Medicare Advantage Plan, some will include Part D as part of the plan. If going on a Medicare Supplement, Part D is additional.

4. Understand the Difference between Open Enrollment and Initial Enrollment

The Annual Open Enrollment is from Oct. 15 to Dec. 7. This is only for people already in Medicare Advantage and Part D who need to change their coverage.

Your Initial Enrollment is based on your birthday when you turn 65. You are eligible to select a plan 3 months before, the month of, and 3 months after and the month of your 65th birthday. The Initial enrollment period is only those 7 Months.

If you choose Medicare Supplements during your initial enrollment you will not need to go through underwriting.

Medicare Supplements (MEDIGAP) DO NOT have an annual open enrollment period. You can sign up for them anytime throughout the year as long as you meet each carrier’s specific underwriting requirements. And each carrier is different regarding health conditions. So it pays to work with someone who shops the market like us. Contact us for help in this area.

5. Don’t Miss a Golden Opportunity

Turning 65? This is a once in a lifetime opportunity for you to get the best coverage at the best price.

There is a 7-month window surrounding your 65th birthday where you are free to enroll in Medicare Supplements without underwriting or medical questions.

Deciding to go with a Medicare Supplement in this window guarantees you coverage. Insurers by law cannot deny you coverage due to a pre-existing condition, but only during this time period.

Think of your family history, consider that as we age we spend more money on healthcare than anything else. This decision can be the difference between enjoying your retirement or scrambling to cover unforeseen medical costs. Don’t be shortsighted and delay because you’re healthy today.

These conditions can be deniable with many supplemental carriers:

  1. COPD
  2. Diabetes
  3. Heart issues
  4. Stroke
  5. Terminal Illness
  6. Transplants
  7. Lupus
  8. Cancer
  9. Dementia

Keep this in mind if you have any of these conditions and are thinking about bypassing Medicare Supplemental coverage during your Initial Enrollment Period.

6. Factor Possible Out-of-Network Costs

Do you have family or friends in other states, or often travel for pleasure? Don’t forget to take this into consideration when choosing a Medicare Supplement or Medicare Advantage plan. Two very important things separate them. Freedom and Confinement.

With a Medicare Supplement, your insurance will be accepted wherever Medicare is – no questions asked.

With a Medicare Advantage plan, you need to be aware of the fine details. You could be subject to prior authorizations and out-of-network costs when traveling. It may not cover your expenses, except for emergent care. Best to know the plan details and the type of lifestyle you plan to live in your retirement years.

So Where Can You Turn To Help Avoid These Mistakes?

SHIP (State Health Insurance Program) lost funding for 2017. SHIP was a go-to resource for 7 million Medicare beneficiaries last year alone. They provided free coverage consultations. Now, demographically speaking, the largest percentage of the population will also be the oldest, this segment will continue to expand in years to come.

It’s fair to say we can anticipate more fee-based consulting coming into the marketplace to find a trusted advisor who can help you. We charge absolutely no fees and are here to help. Please contact us if you or a family member needs help deciding which coverage is best for their unique situation. We can help.

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