Avoid These 5 Medicare Open Enrollment Mistakes

Choosing the Right Medicare Plan: A Comprehensive Guide

Choosing the Right Medicare Plan: A Comprehensive Guide


Choosing or changing a Medicare plan can be overwhelming and confusing. It’s important to carefully do your homework before making any decisions or changes to avoid costly mistakes. The 2022 Inflation Reduction Act has introduced new benefits that you can take advantage of. In this guide, we will provide you with the essential information you need to navigate the Medicare system effectively.

Open Enrollment: Your Time to Make Changes

If you want to make changes to your Medicare plan, the Open Enrollment period is the time to do so. It runs from October 15 to December 7 every year. During this period, current Medicare beneficiaries can sign up for or change their Part D prescription drug coverage, switch between Medicare Advantage plans, or switch between Medicare Advantage and traditional Medicare coverage.

New Medicare Enrollments

New Medicare enrollments typically happen around your 65th birthday month. However, if you miss this window, you will have to wait until the first quarter of the year (between January 1 and March 31) to enroll, and you may have to pay a penalty. In some cases, you may qualify for a Special Enrollment Period, which allows you to enroll without incurring additional lifetime surcharges.

New Benefits to Save You Money

The Inflation Reduction Act has introduced several new benefits to help Medicare beneficiaries save money. These benefits include a $35 monthly cap on insulin and coverage of all CDC-recommended vaccines for individuals aged 65 or older. The act also eliminates cost-sharing for the shingles vaccine, which used to be an out-of-pocket expense for many. In the coming years, there will be further benefits, such as capping prescription drug costs and expanding eligibility for the low-income subsidy program, Extra Help.

Mental Health Services and More

The Inflation Reduction Act has also expanded coverage for mental health services. Marriage and family therapists, as well as mental health counselors, are now included in the Medicare program. This change provides beneficiaries with more comprehensive coverage for their mental health needs.

Avoiding Common and Costly Errors

As you evaluate the insurance options available to you, it’s important to avoid common and costly errors. Here are some suggestions to help you navigate the Medicare system effectively:

Risking a Lifetime Penalty

Enrollment in Original Medicare or Medicare Advantage should generally occur within your initial eligibility window to avoid lifetime penalties. Late enrollment in Medicare Part B, for example, incurs a lifetime penalty of an additional 10% for each year you delay, which is added to your monthly premiums.

Understanding Enrollment Deferral Criteria

If you’re still working and have comparable employer coverage or coverage through your spouse’s job, you may be able to defer Medicare enrollment at age 65. However, the criteria for deferral vary depending on your employer. To understand your options and avoid financial penalties, it’s recommended to call 800-MEDICARE and speak to an expert.

Purchasing Supplemental Insurance Early

During the initial Medicare enrollment period, it’s crucial to purchase supplemental insurance (Medigap) because it’s guaranteed issue. This insurance helps bridge the gap between what original Medicare pays and what the beneficiary pays. If you try to buy it later, insurers are not obligated to issue a policy or you may be subject to higher premiums due to medical underwriting.

Reviewing Your Part D Prescription Drug Plan Annually

Formularies change, and your health needs may evolve over time. It’s important to review your current prescription drug plan during Open Enrollment to ensure it still meets your needs and offers the best financial options. Pay attention to new drugs that may be covered and the associated costs.

Reviewing Your Medicare Advantage Plan Annually

Medicare Advantage plans are required to notify beneficiaries of any material changes in coverage or benefits, including copayments, coinsurance, and deductibles. Make sure to review these changes annually to ensure your plan still meets your needs. Additionally, check if your preferred providers are still in-network.

Choosing the Right Plan

It’s crucial to find a Medicare plan that fits your needs. To help you make an informed decision, review the Medicare and You handbook, which is updated annually. The handbook, along with the Medicare website, provides information on available plans in your area. Avoid being swayed by fancy marketing materials or slick ads that may not accurately represent the coverage offered.


By following these guidelines and staying informed about the latest changes and benefits, you can choose the right Medicare plan that meets your needs and ensures you receive the coverage and benefits you deserve.

Read More of this Story at fortune.com – 2023-10-28 11:00:00

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