5 Medicare mistakes you should avoid during open enrollment.

Millions of seniors have already begun the Medicare open enrollment season, which runs from October 15 through December 7, but many find the process challenging. Sage Growth Partners, a health care consulting firm, conducted a study in July 2022 that found that many consumers don’t understand the differences between Medicare Advantage and Original Medicare, that they are inundated with Medicare advertisements, and that only about four in ten people review their plan options annually.

It’s possible that if you wait until the last minute, you won’t be able to compare Medicare Part D plans for the following plan year or make sure your doctors are in-network.

Below are the Medicare enrollment mistakes you should avoid:

1. Failing to see a doctor in 2023

You’re limited to seeing doctors who participate in your Medicare Advantage plan’s network, and the participating providers in any given plan’s network are subject to change at any time. So before sticking with the plan, examine whether your preferred doctors and hospitals will still be included in the coverage in 2023.

You may need to do some digging, as information on websites and in directories of service providers isn’t always up-to-date.

“I was just at a client, and [the plan] said their doctor was not in-network, and it took us calling the provider and digging up a different site on the network side,” said Evan Tunis, president of Florida Healthcare Insurance. I believe calling the doctor’s office to double-check is the best action. In addition, Medicare open enrollment is the best time to evaluate your current Medicare coverage.

2. Not checking medication plan costs

A private insurance company supplies your prescription drug coverage, whether you have Traditional Medicare or Medicare Advantage, and its coverage may change from year to year. For example, regular prescription medicine might become more expensive in 2023, or your insurance company could stop covering it entirely. (Another policy might pay less to cover it.)

You can get more personalized plan recommendations from Medicare.gov if you input the medications you now use on the website. So here’s some guidance: When you log in to your Medicare.gov account, you’ll have instantaneous access to your entire prescription history.

Katy Votava, president and CEO of Goodcare and a nurse with a background in health economics, says this “makes it a lot easier for them to buy for the following year.” In addition, they won’t have to manually key in each milligram and line.

Remember that COVID-19 was how the “discovery” about retirement was made known to the public.

3. You probably thought that all doctors would accept your PPO plan.

Preferred provider organizations (PPOs) are health insurance plans that let their members see non-network providers at a higher fee. Sometimes, Medicare Advantage PPO enrollees will assume they have complete freedom in selecting their primary care physician. But not all doctors will take patients with out-of-network insurance.

According to Tunis, a doctor can refuse treatment to a plan member at the time of service if they do not wish to be reimbursed. To give you an idea, the Mayo Clinic in Florida refuses to treat anyone with Medicare Advantage because they are not part of their provider network.

Tunis maintains that the “most responsible strategy” to access all available healthcare providers is to choose both Original Medicare and Medicare Supplement Insurance, often known as Medigap.

4. Giving into the pressure of ads

During Medicare’s annual enrollment season, advertising hawk Medicare Advantage plans with attractive benefits such as lower out-of-pocket costs and some coverage for hearing aids, dental work, and eye exams.

Nevertheless, there are other considerations than these bonuses when selecting a health insurance plan. ‘Most of the time, honestly, they do not even cover that much dental,’ Votava said of insurance plans. In addition, you should exercise extreme caution before making any changes to your health insurance plan because of your need for a hearing aid.

Votava stresses the need to check your plan’s coverage of your doctors and medications for the following year.

5. Procrastinating too long before asking for help

Open enrollment for Medicare ends on December 7, but you shouldn’t start your plan until then. If you need help figuring out your health insurance options, programs like SHIP (the State Health Insurance Assistance Program) may be able to help. SHIP program counselors are busy but can help you with your Medicare choices at no cost.

SHIP programs are entirely booked weeks in advance in parts of the country. If you need assistance, as Votava suggests, you shouldn’t wait. You can find a local SHIP by visiting shiphelp.org.

Contact Information:
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