One of the nice things about Medicare is you have more options than ever before, and yet, choosing the wrong options can amount to costly mistakes in 2023.
If you’ve done your research, you may think you have everything figured out, yet you can unknowingly get caught up in the pitfalls. Some mistakes come with your procedures and the coding of the visit. Many people ask “Will Medicare Cover My Procedure” and unfortunately, it’s not a yes or no answer which is why some mistakes can be made. Keep reading to learn about other Medicare mistakes.
12 Costly Medicare Mistakes in 2023
To help you avoid costly Medicare mistakes, we’re outlining 12 of the most common Medicare mistakes you could make in 2023.
Not doing your research early enough. There are many rules for the different parts of Medicare. It’s important to understand the penalties and how having access to a non-Medicare health plan could impact your budget.
Not enrolling at the right time. You have a seven-month window to enroll in Medicare. The enrollment period starts three months prior to your birthday month when you turn 65 and ends three months after your birthday month. If you don’t enroll in Medicare during the enrollment period, you could face a significant penalty, and you’d have to wait until the following January to get coverage.
Making the wrong choice of plans when you turn 65 and still have access to an employer-sponsored health plan. For example, you may benefit more by enrolling in a Medicare plan if your employer-sponsored plan covers less and has higher deductibles and coinsurance fees than the employer-sponsored plan.
Dropping an employer-sponsored group plan that negatively impacts your spouse or children. While it may benefit you to switch to Medicare, by disenrolling from an employer-sponsored group plan, your spouse and children up to age 26 would also be disenrolled from the plan, leaving them to find a potentially more expensive plan on their own.
Believing you can still contribute to your health savings account after you go on Medicare. You must be enrolled in a health plan with a high deductible to have a health savings account, and Medicare doesn’t qualify as a high-deductible plan.
Believing you don’t have to enroll in Medicare at age 65 because you are a retiree, or have a plan through ACA, Tricare, VA benefits or COBRA. These plans pay as a secondary payer to Medicare, which would make you the primary payer.
Not enrolling in Medicare at age 65 if your employee has 19 or fewer employees. In this case, Medicare is the first payer, and your employer-sponsored health plan is the second payer.
Choosing the wrong Medicare plan. Depending on your situation, you could pay less in overall costs by choosing Medicare Parts A, B, D, and Medigap than by choosing Medicare Advantage plan as a Medicare Advantage plan may net higher out-of-pocket costs.
Not getting a drug plan when you first become eligible. The enrollment period for adding a drug plan is October 15th through December 7th. If you miss the enrollment period, you will incur a 1% penalty every month for the rest of your life.
Not checking to see if your doctors are on a Medicare Advantage plan. Health insurers can add or delete physicians every year. If you fail to check that your favorite doctor is still on the plan, you may have to choose another doctor.
Not comparing prescription drug plans. Each prescription drug plan has a formulary which is a list of the brand-name and generic drugs they cover. You will want to choose the plan that covers the prescription drugs you normally take.
Believing all physicians will accept Medicare. You may visit any physician or health provider who accepts Medicare, but not all do.
Final Tips for Avoiding Medicare Mistakes
As you make your decision about Medicare, you will want to weigh your current insurance plan against the benefits of enrolling in Medicare and factor in how being on Social Security could impact your health insurance plan.
Some of the factors to consider to avoid costly Medicare mistakes are:
- Your deductible and the potential for meeting it
- Your out-of-pocket maximum limit
- Your regular medications
- Being employed by a company that has more or less than 19 or 20 employees
Also, be aware that if you are receiving Social Security benefits when you turn age 65, the federal government will automatically enroll you into the Medicare program. If you are also eligible for an employee-sponsored plan, you get Part A at no cost. In this case, you will want to drop Part B coverage as you will have to pay an additional premium on top of what you are paying for your employer-sponsored health plan. All you have to do is mail the card back in with a request to disenroll from Part B.