5 Common Medicare Mistakes and How to Avoid Them

1. Waiting to ask about enrollment timing

The Initial Enrollment Period is seven months around a person’s 65th birthday. Missing it without a qualifying Special Enrollment Period can mean delayed coverage and a late-enrollment penalty. The Part B penalty can last as long as a person has Part B.

A person who is still working may have a different path, but that answer depends on the actual employer coverage. Start early enough to verify it instead of assuming a job or COBRA protects every Medicare decision.

2. Choosing a plan based only on the premium

A premium is real, but it is only one line of the yearly picture. Review deductibles, copays, coinsurance, the maximum out-of-pocket amount where applicable, expected medical use and the Part B premium. A low or $0 plan premium does not make every covered service free.

3. Failing to check doctors, prescriptions and pharmacies

A provider may be in one plan network and not another. A prescription can have different formulary rules, coverage tiers or preferred pharmacies from one plan to the next. Make a written list of the doctors, specialists, hospitals, medications and pharmacies that matter, then check the exact plan year.

4. Delaying drug coverage without confirming it is creditable

Part D has its own rule. Going 63 days or more without creditable prescription drug coverage can create a late-enrollment penalty. Do not assume an employer, retiree or other drug plan qualifies; request the plan’s written creditable-coverage notice and keep it.

5. Treating Medicare as a one-time decision

Provider networks, formularies, premiums, benefits and plan rules can change from year to year. The Annual Notice of Change is a good starting point, followed by a review of current doctors, prescriptions and needs. A yearly review does not obligate a person to change plans; it gives them a chance to make an informed decision.