Understanding and utilizing your Medicare plan wisely is essential for getting the most out of it. Failing to research and learn about your plan’s offerings or neglecting to compare Medicare plans during potential changes may result in increased healthcare expenses.
To assist you in making well-informed decisions, we’ve compiled a guide outlining ten costly mistakes to avoid when selecting a Medicare plan.
Mistake #1: Using Out-of-Network Doctors and Medications
Medicare Advantageplans have formal provider networks and formularies for covered medications. Opting for out-of-network doctors can lead to higher costs. Similarly, using medications not on the formulary can result in full payment for those drugs. If your current plan doesn’t align with your medical needs, consider changing during a qualifying enrollment period.
Discover if your doctor and prescriptions are covered with our online guided Medicare enrollment tool, specifically designed for Medicare Advantage plans.
Mistake #2: Overlooking Additional Benefits
Medicare Advantage plans are gaining popularity because they often offer benefits not covered by Original Medicare, such as dental, vision, hearing, or prescription drug coverage. These extra benefits might come at no additional cost to you. Failing to take advantage of them could result in unnecessary expenses, and beyond potential cost savings, these benefits are designed to enhance your overall well-being.
Mistake #3: Opting for Cash Payments for Medications
While it might seem convenient to pay cash for cheaper medications, especially with available prescription discount card programs, it’s wiser to avoid this practice when you might enter the Medicare Part D drug program’s third coverage stage (the donut hole).
Your drug plan tracks your spending, and paying cash doesn’t count towards your official spending. Consequently, you might not progress out of the donut hole if you use cash for certain medications. Instead, consider using your plan even if it means paying slightly more, as it can help you exit the donut hole faster.
Mistake #4: Not Understanding Your Plan’s Costs
While Medicare Advantage plans generally cap healthcare costs, you are still responsible for certain expenses, known as cost-sharing. This may include deductibles, copayments, and coinsurance. Additionally, it’s crucial to verify your plan’s Out-of-Pocket Maximum (OOPM), which represents the maximum you might spend in a year.
Mistake #5: Relying Solely on Premiums to Choose a Plan
Focusing solely on the monthly premium might be tempting, but it’s essential to delve deeper into the costs associated with using your benefits. Pay attention to deductibles and co-payments for services you’re likely to use. Also, consider your overall costs, including those for prescription drugs you take.
Mistake #6: Overlooking Eligibility for Financial Assistance
It’s crucial to check if you qualify for federal and state programs that offer financial assistance for your healthcare expenses. These programs, such as Medicaid, Extra Help, Low Income Subsidy, and state pharmaceutical assistance, can provide significant support. Even if you think your income might be above the limits, apply anyway, as some programs consider household size. Don’t miss out on potential savings; there’s no harm in applying!
Mistake #7: Ignoring the Impact of Late Enrollment Penalties
When entering Medicare, consider the potential late enrollment penalties for Part B and Part D carefully. These penalties come in the form of additional monthly premiums and can be permanent, lasting for your entire life. If you’re already in Medicare, make sure to maintain Part D drug coverage through a Medicare Advantage Plan or a standalone Prescription Drug Plan to avoid these penalties.
Learn more about Medicare Enrollment Periods here
Mistake #8: Neglecting to Review Changes
Review any changes annually. New specialists, medications, or medical conditions may arise, warranting a reevaluation of your Medicare plan. Be proactive in considering how such changes could impact your Medicare coverage.
Mistake #9: Automatically Renewing Your Plan Without Review
Each year, your plan sends an Annual Notice of Change (ANOC) before the fall Annual Enrollment Period (AEP) with details of plan benefits or costs for the upcoming year. Don’t make the mistake of automatically sticking to your current plan without reviewing these changes. Benefits and networks can change yearly, so take the time to understand your coverage options.
Mistake #10: Not Utilizing the Expertise of a Licensed Insurance Agent
When exploring available plans in your area, it’s beneficial to work with a licensed insurance agent. We can provide strategies to save on prescription drugs, ensuring you make the most informed decisions.
Need help? Call Brady Insurance Marketing: 801-347-2087. Our assistance is at no cost to you