Medicare has many rules and guidelines, and mistakes with these rules could result in costly penalty fees for you. Our caring insurance agent is here to help you avoid Medicare mistakes so you can take full advantage of your benefits and receive the care you need.

Common Medicare Mistakes

  1. Assuming you will be auto-enrolled

While some people are auto-enrolled in Medicare Parts A and B at age 65, it is not a guarantee for everyone. You are auto-enrolled if you are claiming Social Security benefits at least four months prior to your 65th birthday. Assuming you will be auto-enrolled could result in a late enrollment, which would result in a late penalty fee every month for the rest of your life.

If you are receiving any kind of Social Security benefits other than regular retirement benefits, you should contact your local Social Security Office to see if you will be auto-enrolled or not.

  1. Not Enrolling in Part B at age 65

There are many reasons why people may not enroll in Medicare Part B coverage promptly. However, the only reason to delay enrollment and prevent yourself from incurring a penalty is if you already have health insurance coverage that is primary to Medicare. If you are actively working past age 65 for an employer with more than 20 employees and have a group health plan through that employer, then you can delay enrolling in Part B without being penalized. This same rule applies when you have insurance through an actively working spouse’s employer. Delaying Part B enrollment for any other reason will result in a penalty which will be tacked onto your Part B premium once you do enroll and is a lifelong penalty based on how long you delayed enrollment.

  1. Not enrolling in Part D at age 65

As with delayed Part B enrollment, you can be penalized for delaying enrollment in Medicare Part D coverage unless you have another form of creditable drug coverage. Even if you are not taking any medications and do not feel you need Part D coverage, you could still be penalized for not enrolling. We recommend that you enroll in a Part D plan to avoid these penalty fees. There are several Part D plans available for you to choose from.

  1. Enrolling in the wrong Part D plan

Part D plans have formularies that list the drugs and medications included in the plan. Prior to enrolling in Medicare Part D, research your plan options, and take the time to list the medications you take. Your best option is to find a plan that covers all of your current medications. Our insurance agent will be happy to help you find the right type of Part D plan for your needs.

  1. Missing your Medicare Supplement open enrollment period

You are only guaranteed one Medicare Supplement open enrollment period. This period is the best time to apply for a Medicare Supplement plan, as during this guaranteed open enrollment period the carrier is not allowed to ask you health-related questions during your application. Your open enrollment period begins the day your Part B plan becomes effective and continues for six months. If you miss this period, you will most likely need to answer health questions when applying for your supplement plan, and based on your answers the carrier could decline your application, leaving you without supplemental coverage.

  1. Not enrolling in the most cost-effective plan for you

There are two main plans in which you can enroll in addition to Part A and Part B. These are Medicare Supplement and Medicare Advantage plans. These plans differ greatly, making it important that you research each type of plan and learn how they work before deciding which plan is right for you. A few factors which may contribute to which plan you choose include:

  • How often you go to the doctor
  • How much you travel
  • Any pre-existing medical conditions
  • How much you can afford out-of-pocket each month

Our insurance agent will be happy to work with you to determine the right plan for your needs.

  1. Not verifying which Medicare Advantage Plans your providers accept

One significant difference between Medicare Supplement and Medicare Advantage Plans is that Medicare Advantage Plans have networks of participating providers. If you enroll in a Medicare Advantage Plan without verifying that your doctors accept that plan, you could need to change your medical and health care providers to accommodate your Medicare coverage. We recommend that you confirm with your doctors which plans they accept so you can be sure that you choose a Medicare plan that will allow you to continue seeing your favorite health care providers.

Our Recommendations

Here at SBI Benefits, we are committed to helping you find the Medicare plan that is right for you. Our team is always available and ready to help you understand your options and maximize your coverage benefits.

When choosing your plan, we recommend that you:

  • Start early! Know when you are eligible for Medicare and what you need to do to receive future coverage without penalty fees.
  • Understand the different plan types so you can make an informed decision about your coverage.
  • Make sure to check for changes in your plan from year to year so that you can make changes in your coverage as needed.
  • Consider more than just the monthly premium — you also need to know your out-of-pocket costs, such as copays and deductibles and the prices of any medications you take regularly.
  • Know your network requirements so that you can see your preferred health care providers.
  • Ask questions! You should not enroll in a plan unless you understand it. Please feel free to speak with an agent at any time to get the answers you need. There are also many free service organizations who can provide you with information and help you navigate Medicare.

For more information about Medicare coverage in Las Vegas and Sparks, Nevada, and to make an appointment, please contact SBI Benefits today.