5 Medicare mistakes that could cost you

senior woman looking concerned at her medical bills

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For those already on Medicare, or anyone who is about to be eligible, one of the best times to reevaluate your plan or sign up is during the Medicare Annual Enrollment Period (AEP), October 15 - December 7.

During this time, Medicare beneficiaries can enroll in coverage, review their current plan, make changes, or adjust policies for Original Medicare, prescription drug coverage, or Medicare Advantage.

Medicare beneficiaries include individuals age 65 and older, those under 65 receiving Social Security Disability Insurance (SSDI) for a qualifying period, and individuals with End-Stage Renal Disease (ESRD). With so many options available, it’s important to make informed decisions and avoid unnecessary costs.

1. Don’t allow automatic plan renewal to make your choice for you.

Medicare Part D and Medicare Advantage plans automatically renew each year on January 1 unless changes are made. While convenient, this may not reflect your current healthcare needs or financial situation. Plans can change annually, including premiums, deductibles, and coverage details. Review your options carefully.

2. Don’t ignore your plan’s Annual Notice of Change (ANOC).

ANOC letters are typically sent by September 30 and outline any changes to your plan for the upcoming year. Reviewing this document helps you understand how your coverage and costs may change, allowing you to decide whether to keep or switch plans.

3. Don’t base your plan choice on the premium alone.

Low premiums can be appealing, but they don’t tell the whole story. Consider deductibles, copayments, coinsurance, and overall out-of-pocket costs. A low-premium plan may become expensive if you frequently use healthcare services.

Also evaluate additional benefits such as vision, dental, hearing, and wellness programs, which may be included in some plans.

4. Don’t pick a plan based on someone else’s choice.

Medicare plans are highly individual. What works for a friend or family member may not meet your needs. Evaluate plans based on your healthcare usage, providers, prescriptions, and budget.

Key factors to consider include cost, coverage, prescription drugs, provider access, quality ratings, and travel coverage.

5. Don’t assume you don’t qualify for financial assistance.

Programs are available to help cover Medicare costs, including premiums, deductibles, and copayments. Medicare Savings Programs include Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), Qualifying Individual (QI), and Qualified Disabled & Working Individuals (QDWI).

Those who qualify for certain programs may also receive assistance with prescription drug costs. It’s worth exploring these options even if you’re unsure about eligibility.

For more information, visit Medicare.gov or call 1-800-MEDICARE (TTY: 1-877-486-2048). You can also contact your State Health Insurance Assistance Program for personalized guidance.

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