THE FIVE BIGGEST MISTAKES BOOMERS MAKE WHEN ENROLLING
IN MEDICARE Article adapted from the National Council on Aging, www.ncoa.org
Finding the right Medicare plan matters. With hundreds
of policies to choose from, and so much information to
understand, many people guess when choosing a policy
and end up paying too much for a plan that doesn’t cover
what they need.
To help baby boomers avoid making the most common
mistakes, the National Council on Aging (NCOA)
created My Medicare Matters®. My Medicare Matters®
provides a clear and friendly guide to help boomers
evaluate their individual needs, compare their options,
enroll in a plan, and sustain the best coverage for years
to come.
Here are the five biggest mistakes boomers should watch
out for when enrolling in Medicare:
MISTAKE 1: SIGNING UP TOO EARLY OR TOO
LATE FOR MEDICARE AND ITS PARTS
If you are aging into Medicare, your initial enrollment
period is based on your 65th birthday. To avoid longterm
penalties, make sure you know what you have to
choose—and by when. If you or your spouse are still
working when you turn 65 and your insurance meets
certain requirements, it may make sense for you to delay
enrollment in Parts A, B, and D. On MyMedicareMatters.
org, you can take a free, confidential Medicare QuickCheck
and receive a personal report with your initial enrollment
period, or special enrollment period if you or your spouse
are still working, and recommendations about when you
should sign up for which parts of Medicare.
MISTAKE 2: NOT UNDERSTANDING THE
DIFFERENCE BETWEEN A MEDICARE
SUPPLEMENT AND A MEDICARE
ADVANTAGE POLICY
If you are new to Medicare, you have a fundamental
choice to make: enroll in original Medicare or opt into a
Medicare Advantage plan. It is very important that you
understand the pros and cons of both types of coverage.
Original Medicare is a fee-for-service program. Most
consumers supplement the government benefit with
a private Medicare Supplement (also called Medigap)
policy as well as a Part D plan for their prescription drugs.
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A Medicare Supplement policy may cover some services
that are not included under the standard Medicare Parts
A and B as well as some out-of-pocket costs such as coinsurance
costs for care at skilled nursing facilities, the
Part A deductible, and foreign travel emergency care. If
you choose a Medicare Supplement policy, you will pay
an additional monthly premium. You won’t need prior
authorization to use specialists or to get second opinions.
A Medicare Advantage Plan (Part C), on the other hand,
takes the place of original Medicare Parts A and B.
These plans work more like group insurance. They are
sold through approved, licensed insurance companies
and may have an additional monthly premium. Often,
Medicare Advantage plans include prescription drug
coverage as well as services that original Medicare does
not such as health/wellness programs and vision care.
However, a Medicare Advantage plan may also limit a
person’s ability to use doctors and hospitals, and also
require prior authorization to use specialty services.
During open enrollment, you have the option of
changing from one type of plan to another if your needs
have changed.
MISTAKE 3: GUESSING WHEN PICKING
SPECIFIC PLANS
It can be very difficult and time-consuming to compare
all of the plans that are available to you. Many people
try to do their homework, get frustrated, and then
“give up and guess.” Choosing a Medicare plan is too
important to leave to guesswork. Take the time to review
your health insurance needs before your first—and every
subsequent—enrollment period. Think about:
• Do you have health insurance from another source?
• Do you have any chronic conditions?
• Which doctors and hospitals do you use?
• Which prescriptions do you need and what
pharmacies do you get them from?
If you’re unsure about your choices, start with a Medicare
QuickCheck to get a personalized report on your options
and use that to start a conversation with a licensed
insurance agent.
/www.ncoa.org