Senior Savings: Avoiding Costly Medicare Mistakes
Whether you are already enrolled in Medicare or looking ahead, it is important to understand what Medicare covers and when to enroll. From missing enrollment windows to selecting a prescription plan not suited to your needs, Medicare mistakes can be costly.
Understanding your ABCs (and D’s…)
Medicare is the federal health insurance plan for people aged 65+, younger people with qualifying disabilities, or those with permanent kidney failure requiring dialysis or transplant. Coverage is divided into segments:1,2
- Part A (hospital insurance)
- Part B covers (medical insurance)
- Part D covers (prescription insurance)
Know when to enroll
Not enrolling at the right time is one of the costliest mistakes you can make. There is a seven-month window for Medicare enrollment that begins three months before your birth month and ends three months after your birth month. Missing this window could result in a late enrollment penalty.3,4 Enrolling in a Part D program is optional, but, with a few exceptions (e.g., employer coverage), if you do not enroll when you first become eligible, a lifetime penalty will be added to your premium when you do enroll.
Even those with coverage from an employer need to be mindful of enrollment requirements. Did you know that your employer may be able to designate Medicare as your primary insurance when you turn 65?3 Depending on the size of your employer, Medicare may require you to sign up during the Initial Enrollment Period based on your birthday, not retirement – not doing so could result in late penalties.4,5
In short, do your research and know when you need to enroll – it will save you both money and aggravation!
Avoiding Part D mistakes
With as many as 30 options to consider, selecting the right Medicare Part D plan can be overwhelming.2,6 Many seniors simply select the plan with the lowest premium. Others enroll in a plan and then never reexamine it to see if it still fits their needs. With prescription costs varying widely between plans6, selecting the wrong plan can be costly.
Consider your priorities when choosing your plan:
- You currently take medications – look for plans that include your medications in their formulary.
- You want extra protection from high prescription drug costs – look for plans that will offer you coverage in the coverage gap.
- You want drug expenses to be balanced throughout the year – look for plans with a low or no deductible or with additional gap coverage.
- You take a lot of generic prescriptions – look for a plan that offers low or no copayments on generics.
- You don't have many drug costs now (but want peace of mind and to avoid future penalties) – look for a plan with a low monthly premium.
- You prefer the extra benefits and lower costs available by getting your health care and prescription drug coverage from one plan and are willing to accept the plan’s restrictions on what doctors, hospitals, and other health care providers you can use – look for a Medicare Advantage Plan (Part C) that includes prescription coverage. Part C is available through private insurance companies that contract with Medicare.7
Navigating your choices
Medicare.gov, the official U.S. government site for Medicare, can help you select the coverage that best suits your needs. For your Part D plan, the site’s Medicare Plan Finder can help choose and enroll in a plan based on your needs and current medications (have your prescription list handy!)
Plan options change, as do your needs – be sure to reevaluate your coverage annually so that you can change plans during Open Enrollment if there is a better option. It could save you hundreds and even thousands of dollars.
We’re here to help
We know that selecting a Medicare Part D plan can be intimidating. If you are unsure if your current plan is the best one for you or need advice about selecting a new plan, talk to your Health Mart pharmacist.
Nothing herein constitutes medical advice, diagnosis or treatment, or is a substitute for professional advice. You should always seek the advice of your physician or other medical professional if you have questions or concerns about a medical condition.
- Medicare.gov: What Medicare Covers https://www.medicare.gov/what-medicare-covers Last accessed: July 18, 2019
- Medicare.gov: Drug coverage (Part D) https://www.medicare.gov/drug-coverage-part-d Last accessed: July 18, 2019
- AARP: How to Avoid These Common Medicare Mistakes https://www.aarp.org/health/medicare-insurance/info-2019/common-medicare-mistakes.html Last accessed: July 18, 2019
- Very Well Health: The Top 6 Mistakes Seniors Make When It Comes to Medicare Enrollment https://www.verywellhealth.com/top-mistakes-seniors-make-with-medicare-enrollment-2318676 Last accessed: July 18, 2019
- CNBC: Here’s how to avoid costly Medicare mistakes when retiring after age 65 https://www.cnbc.com/2019/07/19/avoiding-costly-medicare-mistakes-when-retiring-past-age-65.html July 19, 2019
- Henry J. Kaiser Family Foundation: An Overview of the Medicare Part D Prescription Drug Benefit https://www.kff.org/medicare/fact-sheet/an-overview-of-the-medicare-part-d-prescription-drug-benefit/ Last accessed: July 18, 2019
- Medicare.gov: 6 things to look for when choosing Medicare drug coverage https://www.medicare.gov/drug-coverage-part-d/how-to-get-drug-coverage/6-things-to-look-for-when-choosing-medicare-drug-coverage Last accessed: July 18, 2019