Common Medicare Mistakes

Many people assume that when they sign up for Social Security they will sign up for Medicare at the same time.  They also expect the procedure to be fairly simple and uncomplicated.  While sometimes this is true, it isn't always.  Decisions about when to sign up for Medicare, which parts you should enroll in, and what supplemental policies to purchase can be very complex.

Many people make mistakes when they initially sign up for Medicare.  When they do, it can make a significant difference in what they will pay in premiums for the rest of their lives.  Below are the most common mistakes retirees make.  It is important to educate yourself BEFORE you sign up.  While you can make some changes later, for example in which supplement you want to use, other mistakes are irrevocable.

Common Medicare Mistakes

*  Do not assume that you do not qualify for Medicare if you have not worked long enough to qualify for Social Security (a total of about 10 years).  If you are age 65 or older, you qualify for Medicare Parts B and D as long as you are a U.S. citizen or a legal resident who has lived in the U.S. at least five years.  You might not qualify for Part A if you have not worked long enough, but you could qualify on a spouse's work record or you can pay premiums for Part A.  Go to your local Social Security office during the three months before you turn 65, or before another 3 months have passed afterwards, so you know your options ... even if you do not plan to start collecting your Social Security benefits for a few more years!

*  Do not postpone signing up for Medicare Part B, unless you have health coverage beyond age 65 through an employer or spouse's employer, and the employer has 20 or more employees.  Other than that exception, the seven month window for signing up is the month you turn 65, three months before and three months after.  If you fail to sign up on time, you will pay a penalty, in the form of a surcharge, for the remainder of your life.

*  Retirees covered by a COBRA or a retiree plan from an employer often still need Medicare Part B.  Many of these plans are set up to be a supplement to Medicare Part B.  If you fail to sign up on time, you'll have no coverage for doctors' services, outpatient care and medical equipment until you enroll.  You need to sign up either during your regular seven month window, or no later than eight months after you stop working (if you work past the age of 65).

*  Do NOT wait until your "full retirement age" or until you collect Social Security before you sign up for Medicare.  As mentioned above, the window for signing up for Medicare is NOT the same as your full retirement age.  They are not linked.  If your full retirement age is 66 or 67, you still need to sign up for Medicare around your 65th birthday, with the few exceptions mentioned above.

*  Do NOT postpone signing up for Part D drug coverage, just because you currently do not take any drugs.  You will end up paying extra penalties and have a delay in coverage when you need it.  One way to save money is to sign up for the Medicare approved Part D plan in your area with the lowest premiums. If you do use prescription drugs, you can research which plan is best for you by using the plan finder program on Medicare.gov or by calling Medicare at (800) 633-4227.

*  Do not get confused about the meaning of open enrollment.  The widely advertised open enrollment period of Oct. 15 to Dec. 7 each year only applies to people who are already on Medicare and wish to change their coverage.  If you are new to Medicare, you can sign up for a supplement or Medicare Advantage plan any time of year.

*  Do NOT wait too long to choose a Medicare Supplement or Medicare Advantage plan.  Since basic Medicare only covers about 80 percent of most medical bills, the majority of people will want to use either a Medicare Supplement or a Medicare Advantage plan.  You need to enroll in one within six months of enrolling in Part B.  If you do that, you cannot be denied coverage or charged higher premiums because of a preexisting medical condition ... no matter how sick you are.  This is a one-time opportunity.  If you are not happy with the plan you initially selected, in most cases you can change it each year during the open enrollment period. (Your choices may be limited if you have end-stage renal failure). If you sign up for Part B when you turn 65, but you do not get a supplemental policy within six months because you are still working and have employer provided insurance, you lose the federal protection against being charged higher premiums because of a preexisting medical condition.

*  Make sure you understand the difference between a Medicare Supplement and a Medicare Advantage Plan.  Both are available across the United States.  A Medicare Supplement is a policy you buy in addition to paying for your Medicare benefits.  You normally have a wider choice of doctors and hospitals; however, they are typically more expensive than a Medicare Advantage Plan and you are basically paying for and dealing with two insurance companies ... the basic government Medicare agency and the insurance carrier handling your Medicare Supplement.  A Medicare Advantage Plan limits you to their group of doctors and hospitals.  However, they are typically less expensive and sometimes cost no more than basic Medicare, yet offer better coverage.  In addition, you only need to file claims and deal with the Medicare Advantage insurance company.  They handle government claims for you.

*  Do not ignore the Annual Notice of Change.  It will be mailed to you every September if you are enrolled in a Medicare Advantage plan (either HMO or PPO) or a Part D prescription plan.  It will explain what changes in coverage and premiums will be made for the coming year.  After reading it, you can decide if you want to select a different plan during the fall open enrollment period.  This could help you avoid a nasty shock from rising premium prices or changes in coverage.

*  Do not forget that many retirees qualify for financial assistance.  This is not charity.  You are entitled to this assistance and extra benefits.  If money is tight, find out if you qualify for these programs:

Medicare Savings Program - Your state will pay the Part B premiums and possibly other expenses.

Federal Extra Help - You could qualify for low-cost Part D prescription drug coverage.

To find out if you qualify, contact your State Health Insurance Assistance Program (SHIP).  You can find the toll-free number at:   shiptacenter.org

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