3 Medicare Enrollment Mistakes to Avoid

by Nancy Metcalf Health Writer

If you are on Medicare, there’s no hiding from open enrollment season, which runs from now through Dec. 7. Your mailbox is probably overflowing with insurance company flyers right now, and even Medicare itself is placing ads on the nightly news reminding you to check on your plan.

You may be tempted to tune it all out. Don’t. It could cost you. Here are three Medicare enrollment mistakes you definitely don’t want to make.

1. Not reviewing your coverage

Those TV ads are right. If you do nothing, you’ll automatically be re-enrolled in your current plan. The problem is that plans change a lot from year to year. If everyone stays with the same drug plan they already have, their premiums will go up an average of 9 percent in 2017, according to an analysis by the Kaiser Family Foundation.

To review your coverage, go to Medicare.gov and create an account if you don’t already have one. Then go to the Medicare Plan Finder and follow the on-screen prompts to enter the drugs you take. You’ll end up with a personalized listing of plans in order of annual cost.

2. Declining drug coverage because you don’t take meds

If you are among the 30 percent of beneficiaries who get your Medicare coverage through a private Medicare Advantage plan, drug coverage is built in.

But if you opted for regular Medicare, plus a supplemental Medigap plan, you have to enroll in an optional standalone Part D plan to get any coverage for prescriptions. With an average premium of $42.17 a month for 2017, if you don’t take any drugs regularly you might be tempted to put off enrolling to save money.

But that’s a mistake, for two reasons. One, you can only enroll once a year (except if you’re joining Medicare for the first time), so if you should end up unexpectedly needing expensive medication during the year, you’ll be paying out of pocket for it.

Two, Medicare will make you pay a permanent penalty on your premium if you don’t enroll in Part D at the same time you sign up for Part B. The penalty is assessed for every month you should have been on Part D but weren’t. You’re stuck with it for life and it goes up a little bit every year.

The solution is to enroll immediately in the cheapest Part D plan in your locality. The only way to get out of the penalty is if you have equivalent drug coverage from some other source, such as a retiree plan or TRICARE.

3. Assuming you can switch to Medigap

Eighty percent of people in Medicare Advantage can get a plan for nothing. But those plans come with significant deductibles and, unlike regular Medicare, have restricted provider networks.

Medigap plans, though sometimes pricey, have little if any out-of-pocket costs and no network restrictions. Still, don’t plan on being able to switch to a Medigap plan if you ever develop a serious medical condition.

That’s because your right to enroll in Medigap is a one-time-only offer that expires six months after you sign up for Part B. After that (except in a few states that have enacted additional consumer protections), Medigap plans can turn you down or charge you extra if you have a pre-existing condition. And even if they take you, they can make you wait six months before paying for pre-existing conditions.

To learn more about your Medicare benefits, find the right coverage, or to understand how any existing coverage works with Medicare, contact the National Helpline..

Nancy Metcalf
Meet Our Writer
Nancy Metcalf

Nancy Metcalf is an award-winning independent journalist specializing in health topics. A senior writer and editor for Consumer Reports for more than 25 years, she is a nationally recognized expert on health insurance and health reform.