Maximizing the benefits of your Medicare plan and using it wisely is crucial for optimizing its value. Failing to research and familiarize yourself with your plan’s offerings, or neglecting to compare Medicare plans during potential changes, could lead to increased healthcare expenses.
To assist you in making well-informed decisions, we have compiled a guide outlining ten costly mistakes to avoid when selecting a Medicare plan.
Mistake #1: Opting for Out-of-Network Doctors and Medications
Medicare Advantage plans have formal provider networks and formularies for covered medications. Choosing out-of-network doctors may result in higher costs, and using medications not on the formulary could lead to full payment for those drugs. If your current plan doesn’t align with your medical needs, consider changing during a qualifying enrollment period. Use our online guided Medicare enrollment tool, specially designed for Medicare Advantage plans, to determine if your doctor and prescriptions are covered.
Mistake #2: Overlooking Additional Benefits
Medicare Advantage plans are increasingly popular due to their additional benefits not covered by Original Medicare, such as dental, vision, hearing, or prescription drug coverage. These extra benefits may come at no additional cost to you, and failing to take advantage of them could result in unnecessary expenses. Beyond potential cost savings, these benefits are designed to enhance your overall well-being.
Mistake #3: Opting for Cash Payments for Medications
Paying cash for cheaper medications might seem convenient, especially with prescription discount card programs, but it’s wiser to avoid this practice when you might enter the Medicare Part D drug program’s third coverage stage (the donut hole). Cash payments don’t count towards your official spending, potentially preventing you from progressing out of the donut hole. 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, 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, and consider your overall costs, including those for prescription drugs you take.
Mistake #6: Overlooking Eligibility for Financial Assistance
Check if you qualify for federal and state programs that offer financial assistance for your healthcare expenses, such as Medicaid, Extra Help, Low Income Subsidy, and state pharmaceutical assistance. 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 enrolling in Medicare, carefully consider the potential late enrollment penalties for Part B and Part D. These penalties can lead to additional monthly premiums and may be permanent, lasting for your entire life. If you’re already in Medicare, ensure you maintain Part D drug coverage through a Medicare Advantage Plan or a standalone Prescription Drug Plan to avoid these penalties.
Mistake #8: Neglecting to Review Changes
Review your plan annually for any changes. 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.”
Ready to start a plan? Call us (971) 233-3637. Our assistance is at no cost to you.