Common Medicare Mistakes

When it comes to making key decisions regarding your Medicare plan, oftentimes there are certain details that go overlooked which can cause problems years later. It is important to read the fine print of Medicare documents so that you have a firm understanding of what you are signing up for, and what you won’t sign up for. Instead of jumping through many unnecessary hoops before acquiring the right Medicare plan for you, here are some of the main Medicare mistakes to avoid:

 

  1. Purchasing the same Medicare Supplement plan as my spouse or partner
    • Also known as Medigap, you can buy a Medicare Supplement insurance plan to cover out-of-pocket costs that neither Medicare Part A nor Part B cover, such as deductibles and coinsurance. You can even get limited coverage of foreign travel emergencies from a Medicare Supplement insurance plan
    • Couples are often insured under the same health benefits via employers or individual markets prior to Medicare eligibility. It is assumed that it is easier to continue that when enrolling for Medicare plans. Although it is possible to purchase the same Medicare plan as your spouse, it’s not advisable to do so for the purpose of simplicity.
    • Each spouse has a unique health history and specific health needs. If the same plan is chosen, one spouse can possibly experience much higher expenses than necessary and, depending on the plan chosen, could result in that spouse being permanently excluded from certain Medicare plans.
  2. Assuming you can forgo Medicare for your employer’s health insurance
    • Signing up for a Medicare plan is essential, but did you know that Medicare can either be the primary or secondary payer to your current insurance through your employer? The difference is critical to your coverage. If Medicare is the primary payer, then Medicare will pay expenses first. The health insurance you have via your employer will pay second and cover either a portion or all of the remaining costs. If Medicare is the secondary payer, then your employer’s insurance is obligated to pay first, with Medicare covering any remaining costs. The key determinant in which pays first or second is the number of employees with your employer.
    • For most Americans, it is not wise to forgo having a Medicare plan in place because approximately 85% of employers based in the United States employ less than 20 employees. These Small Group Health plans often provide attractive benefits and can cause someone to delay Medicare enrollment. Unfortunately, this means the employer plan will be the secondary payer. Without Medicare, you will not have a primary payer in place and all medical expenses will be uncovered.
    • Additionally, if you have gone longer than 3 months past your Medicare eligibility date, then you must wait until the next Medicare Open Enrollment Period (January through March) for a July 1st effective date. This can lead to additional delays in coverage, increased medical expenses and penalties.

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