Seven common Medicare mistakes to avoid

Not signing up for Medicare at the right time: As you approach 65, you’ll want to enroll during what the government calls your initial enrollment period (IEP). This seven-month period goes from three months before the month in which you turn 65 until three months after. If you don’t sign up during your IEP, you will get another chance to enroll during Medicare’s annual general enrollment period from Jan. 1 through March 31 of each year.

Blowing the special enrollment period: If you are 65+, when you stop working and lose your health insurance coverage, you’ll need to sign up for Medicare. Medicare has created a special enrollment period (SEP) that lets you do that without facing a late-enrollment penalty.

Delaying enrollment when your job insurance is second in line: Even when you have job-based insurance, some employers, depending on their size, can designate Medicare as your primary health coverage when you turn 65. The way to find out if your job-based insurance is considered primary or secondary is to ask your benefits manager or human resources department, or seek help from 1-800-MEDICARE.

Not understanding Part B and Part D late-enrollment penalties: For every 12 months you delay enrolling in Part B, your monthly Part B premium may be 10% higher. The penalty won’t apply if you have job-based insurance or are still under your special enrollment period. For every 12 months you delay signing up for a Part D plan, your monthly premium may be 1% higher.

Not fully comparing original Medicare with Medicare Advantage (MA) plans: If you are eligible for Medicare, you have a choice to receive your benefits through original Medicare or a MA plan. Original Medicare is the traditional program offered directly through the federal government. It comprises Part A, which covers hospital costs, and Part B, which covers doctor visits and other outpatient services. Original Medicare does not include Part D, so you must sign up for a stand-alone Part D plan if you do not have other drug coverage. Original Medicare does not have a limit on your annual out-of-pocket costs. Medicare Advantage is a private insurance alternative to original Medicare. These plans provide Part A, Part B and usually Part D benefits. They may also offer certain benefits that original Medicare does not cover, such as dental/vision care. Some MA plans may also provide some non-traditional services, such as paying for wheelchair ramps or meals delivered to beneficiaries’ homes. These MA plans have an annual out-of-pocket limit, and you cannot buy a Medigap policy when you are enrolled in MA.

Delaying buying a Medigap policy: Medigaps are supplemental health insurance policies that work with original Medicare. The best time to buy a Medigap policy is during your Medigap open enrollment period. Some states have their own rules governing Medigap policies, so if you made this mistake and didn’t sign up during your enrollment period, check with your State Health Insurance Assistance Program (SHIP) at shiptacenter.org to ask about state-specific Medigap rights.

Assuming you can’t afford Medicare: If you have a limited income, you may be able to get assistance with your health costs through certain programs. Medicare Savings Programs (MSPs) help pay the monthly Part B premium and may help with Medicare cost sharing, depending on the program. Contact your SHIP at shiptacenter.org to learn if you are eligible for an MSP. Extra Help is a federal program that helps pay for some of the costs of Medicare Part D prescription drug coverage. Contact the Social Security Administration at 800-772-1213 or visit ssa.gov to learn if you are eligible for Extra Help and to start an application. State Pharmaceutical Assistance Programs (SPAPs) are offered in some states to help eligible individuals pay for prescriptions.

Interested in learning more about Medicare? Join a free one-hour webinar – Medicare and its Alphabet Soup – with a representative from SHIP (Indiana Department of Insurance). SHIP offers free and impartial counseling for people with Medicare. The webinar is Aug. 6 from 5-6 p.m. on Zoom. Register at: https://bit.ly/3iN4xmY.

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