10 Costly Medicare Mistakes to Avoid: Tips for a Smooth Enrollment Process
Navigating Medicare enrollment can be daunting, and even small mistakes can lead to significant financial and healthcare challenges. Whether it is missing key deadlines, misunderstanding coverage options, or overlooking essential benefits, these errors can impact your budget and access to healthcare. This guide highlights the 10 most common Medicare mistakes and offers practical tips to avoid them. By understanding these pitfalls and taking proactive steps, you can make an informed choice to secure the best Medicare plan for your needs.
Mistake #1: Missing the Enrollment Deadlines
If a qualifying individual fails to sign up for Medicare during the initial enrollment period (IEP), there is a financial penalty— monthly premiums can increase as much as 10%.
The initial enrollment period for Medicare is from three months before your 65th birthday to three months after. If this time period is missed, you can enroll during the general enrollment period, January 1st through March 31, but this may result in a late enrollment penalty if you do not have other creditable coverage, such as group health insurance.
To enroll in Medicare, click this link to the Medicare website and follow the instructions carefully.
Mistake #2: Not Reviewing All Coverage Options
Often mistakes are made during the enrollment period because people do not understand their Medicare coverage choices. The two main ways people access their Medicare benefits are:
Original Medicare
Also known as Parts A and B, Original Medicare covers basic medical services such as inpatient hospital care, hospice care, some outpatient hospital services, ambulance, and laboratory services. Original Medicare is managed by the United States federal government.
Medicare Advantage
Medicare Advantage, also known as Part C, covers the same services as Original Medicare Parts A and B and may also include prescription drug coverage (Part D) and additional benefits. Medicare advantage plans are provided by pre-approved private insurance carriers. Coverage varies by carrier.
A Medicare Advantage plan may be right for you if you are in need of, or may be in the future, coverage beyond original Medicare. For more information on the different types of Medicare plans, see our guide to the types of Medicare Health Plans here to make an informed choice.
Mistake #3: Failing to Sign Up for Prescription Drug Coverage (Part D)
Medicare Part D plans offer coverage for prescription drugs. Like Medicare Advantage, these plans are provided by private insurance carriers. For many, perscription drug coverage is a must.
When enrolling in Medicare, be sure to evaluate your personal medical circumstance, as well as your family’s medical history. Do you, or will you likely, need insurance coverage for prescription drugs? If you answer yes, or even maybe, to this question explore the different prescription drug coverage plans.
The enrollment periods for Original Medicare—three months before your 65th birthday to three months after—also applies to Medicare Part D. Failure to sign up during the initial enrollment period will result in late penalties. A penalty of 1% per month of the national average Part D premium will be charged as a late enrollment penalty should you fail to enroll in Part D coverage when eligible. The penalty is not applied if you have other creditable coverage for prescriptions.
Mistake #4: Overlooking the Costs of Medicare
Medicare costs include monthly premiums (the dollar amount you pay each month) and deductibles (the out-of-pocket amounts you must pay before coverage begins). Copayments and coinsurance are additional costs that a patient pays for services, such as a flat fee for a doctor visit or a percentage of the cost for a hospital stay.
These costs greatly differ between Original Medicare, Medicare Advantage, and Prescription Drug Plans. With all of these potential different monthly expenses, it is important to review each plan’s details carefully so that you can make an informed choice and manage your healthcare budget effectively.
Mistake #5: Not Reviewing Plans Annually
Each year, Medicare plans can change—these changes usually affect the premiums or the benefits. During the Annual Election Period (AEP), between October 15 and December 7, beneficiaries can switch, join, or drop their plans. When re-enrolling in Medicare, these changes should be reviewed to make sure your plan is fitting to your medical needs.
For example, in 2025 Medicare Part D will undergo some changes: Out-of-pocket costs will be reduced, and the pricing structure, the costs of medications and how you receive bills, will change. For more information on the 2025 changes to Medicare Part D, see a detailed update here.
Mistake #6: Failing to Enroll in Supplemental Coverage (Medigap)
Medicare Supplement Insurance, known as Medigap coverage, offers coverage for deductibles, coinsurance and copayments for services covered by Original Medicare. There are about 10 different Medigap plans available through private insurers but plans vary by state.
The Medigap enrollment period is 6 months after you enroll in Original Medicare. If you don't enroll during your open enrollment period, you will be subject to underwriting, which means that the company can ask you health questions and potentially deny you coverage. Please note, since Medicare Supplement plans work with Original Medicare, you cannot enroll in both a Medicare Supplement plan and a Medicare Advantage plan.
Mistake #7: Ignoring State-Specific Medicaid Options
If you qualify for Medicaid, be sure to review your state’s options for coverage and collaboration with Medicare. While each state’s policies vary, most Medicaid plans can cover costs such as deductibles, co-pays, and premiums. Additionally, in some states, Medicaid will help cover costs not covered by Medicare: these can include long-term care, and non-emergency medical transportation.
To find your state’s medicaid information, follow this link to Medicaid’s website. Be sure to carefully assess your state specific medicaid options.
Mistake #8: Not Seeking Professional Help or Guidance
Navigating Medicare without professional help can lead to costly mistakes, such as selecting a plan that doesn't meet healthcare needs or overpaying for unnecessary coverage. The complexities of premiums, deductibles, and plan restrictions makes it challenging to identify the best option. To avoid these risks and make an informed choice, contact one of our insurance agents here or learn more about the different parts of Medicare here.
Mistake #9: Not Taking Advantage of Preventative Services
Both Medicare Part B and Medicare Advantage cover preventive health services. Medicare Part B will cover various cancer screenings, yearly wellness visits, and diabetes management training (see a complete list from Medicare.gov here).
While some of these services may seem tiresome, the results can greatly increase your health and longevity, as well as help lower healthcare costs down the line. Be sure to review the preventative care services your Medicare plan provides.
Mistake #10: Forgetting to Keep Track of Healthcare Records
Keeping track of healthcare records is essential for monitoring claims, payments, and services received. This will help you ensure bill accuracy and prevent charge errors, as well as help determine which plan costs you will qualify for. Failure to review and regularly organize these records, can lead to unnecessary, out-of-pocket charges which should be covered by Medicare plan benefits.
How to Avoid These Costly Mistakes and Ensure a Smooth Enrollment
Enrolling in Medicare is a critical step in securing your healthcare needs, but it requires careful planning and attention to detail. By understanding these 10 costly Medicare mistakes you can avoid unnecessary expenses and ensure you have the right coverage for your needs. Take the time to make informed decisions today, and enjoy greater peace of mind in your healthcare journey.
Get Expert Help with Your Medicare Enrollment from Informed Choice
If you are unsure where to start or want expert advice, our experienced agents are here for you. With personalized recommendations and ongoing support, we are here to help you select a Medicare plan that meets your needs. Contact us today to take the next step in securing your health and financial protection. Remember, seeking professional guidance and staying informed about your plan’s details will maximize your benefits and reduce the
