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10 Common Medicare Mistakes and How to Avoid Them



10 Common Medicare Mistakes and How to Avoid Them

Medicare is a complex and sometimes confusing system, but it’s also a crucial part of the healthcare landscape in America. Around 93,373,794 people in the United States are currently enrolled in Medicare. Understanding how this system works will help you from making some of the most common Medicare mistakes.

From using out-of-network doctors to paying cash for prescriptions, there are some missteps that will cost you money and stress. To help you navigate the Medicare system, we’ve rounded up 10 common mistakes and how to avoid them.

Think of this as your go-to guide to Medicare 101.

1. Using Doctors and Medications That Aren’t Covered

If you’re in Medicare, chances are good that you’ve run into at least one of these common mistakes. Not understanding Medicare CGM requirements 2023 is one of them, for example. This falls under the category of using doctors and medications that aren’t covered by your plan.

If your doctor prescribes a medication or treatment that isn’t covered by your plan, you could end up with a big bill. This may have happened to a spouse as well. This leaves you with debt and bills that are hard to pay on a fixed retirement income.

Luckily there are ways to find out whether something is covered before getting treatment. Make sure you check if a doctor or medication is covered.

If they aren’t in your network, get a recommendation for someone who is. This way you aren’t surprised by a bill if you choose to pay out of pocket for a provider.

In terms of medications, you also have options. Doctors may also work with you on different brands of medications that better fit your budget and plan.

There are often generic alternatives to many common medications. The cost of Medicare doesn’t have to put you in financial distress.

2. Not Enrolling in Medicare

If you have a Medicare Advantage plan and are enrolled in Part D, or if you have a Medigap policy that covers prescription drugs and are enrolled in Part D, it’s important to know that signing up for Original Medicare does not mean that you need to cancel these other plans.

In fact, it’s quite possible for an individual or couple to be on both types of coverage at once. Doing so could result in some extra costs and confusion so make sure to double-check what coverage you have.

3. Missing the Medicare Enrollment Period

Mistakes can happen, and you don’t want to make one that could be easily avoided. Missing the Medicare enrollment period is one of the most common mistakes made.

Check the Medicare website for the current enrollment period. Speak with your insurance provider and health professionals as you get ready to make the switch.

4. Paying Cash for Prescriptions

One of the easiest mistakes to make when it comes to Medicare is paying cash for prescriptions. It’s tempting, especially if you’re trying to save money on your monthly drug plan premiums or want more control over how much you spend on them. But this can lead to some big financial problems down the road.

To start, you might not have enough coverage through your insurance plan if something goes wrong with one of the medicines. This happens if it was not covered under its terms. Let’s say a medication wasn’t prescribed by an authorized provider, for example.

To avoid paying cash for prescriptions, ask your provider which medications are covered. This will help you avoid expensive bills out of pocket. This will also help make sure your prescriptions stay affordable.

5. Not Knowing What Additional Medicare Benefits You Paid For

Medicare Advantage plans are health insurance plans that combine Medicare benefits with those of a private insurer. These plans often include prescription drug coverage and sometimes dental, vision, and hearing benefits as well.

If you have a Medicare Advantage plan, it’s important to know what extra benefits you may have paid for in addition to your monthly premium. You don’t want to double-pay or seek additional coverage if you already have it.

The following list includes some common extras:

  • Prescription drug coverage (Part D)
  • Supplemental Insurance (Part B)
  • Premiums (for both Parts A & B)

6. Failing to Consider Medicare Part B and Part D Premiums

In addition to the cost of your health care services, you should also consider Medicare Part B and Part D premiums. These are the monthly payments that you must make in order to receive coverage for these plans.

The amount you pay for each plan depends on your income level and whether or not you have a secondary insurance plan through an employer or union. If you’re eligible for premium assistance also known as a low-income subsidy, then the government will cover most of these costs. Otherwise, they’re based on what plan type is best suited for your situation.

Keep these premiums in mind to keep your monthly budget in check. On a fixed retirement income, for example, there isn’t always room for unexpected expenses.

7. Not Understanding When You’ll Get Your First Medicare Card

You will receive your Medicare card in the mail about three months before you turn 65. You will also get it when you enroll for Part B if you are already receiving Social Security benefits.

If you don’t receive it within that time frame, call the Medicare offices to request a new one. You can also get a copy of your card online by visiting and entering some basic information about yourself.

8. Forgetting Other Plans and Options for Medicare Coverage

It’s common for people to forget other coverage. You might be eligible for coverage through other programs and past employers.

Medicaid is a joint federal-state program that provides health care coverage to low-income people. If you qualify, it’s best to enroll in both Medicare and Medicaid at the same time.

If you don’t qualify, then try to get on another plan as soon as possible. They can help pay some of your medical bills while you wait for Medicare benefits to kick in.

Other coverage also comes from the Veteran’s Administration (VA) Benefits Program or TRICARE Reserve Select (TRS). These military health plans may also offer some coverage options for veterans who have served in military branches in the United States.

9. Not Looking at Financial Assistance

You may be eligible for financial assistance with your Medicare costs. The government offers a number of different programs to help people who have limited income or resources, including the Medicare Savings Program (MSP) and Extra Help with Premiums (EPP).

If you don’t look into these options, you could end up paying more than necessary on your health insurance premiums each year. To find out if you qualify for financial assistance or other benefits through Medicare, visit the official website.

If you are a low-income household, you’ll want to take advantage of these government assistance programs. They will help offset the cost of medical coverage, prescriptions, care, and more. This is a huge help to those on a limited income.

10. Automatically Renewing Your Plan Each Year

You may be automatically enrolled in the same plan each year. If you don’t want to change your coverage, this is fine.

If there’s another option available that costs less or provides better benefits, it’s worth reviewing the options and possibly making a switch. You may also experience life changes that require updates.

If you do decide to stick with your current plan, it’s important to remember that Medicare Advantage plans have their own open enrollment periods. During this time frame, if something changes in your life such as a spouse passing or moving, you want to update your information.

In some cases, different life events make plans no longer suitable for your needs. Switching could save money on premiums or help ensure that all members of your family have access to important medical services.

You’ll also want to change your plan if you’re experiencing financial hardship. Changes in income, savings, or other emergencies happen. Adjust your plan to make sure you get the coverage and financial assistance you need.

Avoid These Common Medicare Mistakes

There are many things to consider when choosing a Medicare plan. To avoid common Medicare mistakes, it’s important that you do your research and ask questions. From overpaying to not having enough coverage, these mistakes will cost you time, money, and stress.

For more great health and finance resources, head to the blog section. You’ll find tips, guides, and more to help you plan for the future. Let’s make sure your golden years stay golden.