Health Care Quarterly:

Mistakes people make when enrolling in Medicare

According to the Pew Research Center, 10,000 people become eligible to enroll in Medicare every day. If you or a loved one are turning 65, enrolling in Medicare may seem like an intimidating process — but it doesn’t have to be.

Mistake One: Assuming you’ll be signed up automatically

A lot of people assume that enrollment in Medicare happens automatically when you turn 65. However, the automatic enrollment is only for individuals who are currently receiving Social Security benefits. If you are not receiving Social Security benefits, you’ll need to actively enroll in Original Medicare which includes Part A for hospitalization and Part B for doctor visits and outpatient treatments. If you use medication, you’ll also need to enroll in Medicare Part D, which covers prescriptions.

If you’re aging in to Medicare eligibility, you’ll have a seven-month window to enroll that spans the three months prior to your 65th birthday, the month of your 65th birthday, and the three months after your birthday.

You’ll want to make this a priority, because there are financial penalties for not enrolling in Part B and Part D when you’re first eligible — and the surcharges can be added to your premiums for all future years. This could also delay your coverage’s effective date.

Mistake Two: Choosing the same coverage as someone else

It’s easy to think that you need the same coverage as your spouse or best friend. However, when it comes to Medicare, one size does not fit all! It’s extremely important to think about your individual health care needs when considering your benefits. Take the time to properly evaluate the specifics of every plan available to you. When choosing a plan, think about the ways you access care, and make sure that you select a plan that allows you to access care you need. Take the time to review everything your medical group offers, such as access to a robust network of specialists. These integrated members of your care team are especially important if you have a chronic condition.

Mistake Three: Thinking you don’t need Medicare

It’s easy to think that you don’t need Medicare coverage if you’re covered through your current employer, or if you have coverage through a retiree plan, COBRA — the program that allows you to extend employer coverage for 18 months after losing or leaving a job — or an individual plan purchased through a state health exchange.

However, if you’ve recently turned 65, you can’t rely on these options to serve as your main source of health care coverage. Most hospitals and medical groups will only count these as secondary insurers even if you haven’t enrolled in Medicare, which can leave you to cover excessive medical bills.

Mistake Four: Assuming everything is covered

Original Medicare typically does not cover long-term care, nursing home care, dental, vision, hearing, or alternative therapies. But some Medicare Part C, or Medicare Advantage, plans pay for things that are not covered by Original Medicare. It depends on the plan, but these services could include vision and dental care. Again, it’s important to carefully review and consider all the options available to you if you need, or anticipate needing, these types of services.

Mistake Five: Thinking Medicare is too expensive

It’s easy to think Medicare coverage is expensive, but if you’re still working, it’s possible Medicare will be less than what you’re paying for health insurance premiums through an employer. This is especially the case if you choose a Medicare Advantage plan. These plans are offered through private companies but you must enroll in Original Medicare prior to enrolling in a Medicare Advantage plan. Additionally, most Medicare Advantage Plans offer extra coverage and benefits that can include health and wellness programs, and even care management programs to help you manage a chronic disease.

Enrolling in Medicare doesn’t have to be an overwhelming process. If you’re prepared, and know what to look for, this time can be a great opportunity to protect your overall health and your nest egg. For more information about how to enroll in Medicare, and to learn more about Medicare Advantage, please visit www.enrollwithmedicare.com.

Dr. Anjali Rege is a primary care provider at HealthCare Partners, a DaVita Medical Group.

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