• Home
  • /
  • Blog
  • /
  • 5 Medicare Plan Mistakes You Don’t Want to Make
August 15, 2023

Making mistakes when selecting a Medicare Plan can be costly and stressful. Unfortunately, many people make the same errors when choosing a plan. Knowing what these common mistakes are can help you avoid them and make the best decision for your situation. In this blog post, we’ll explore the five biggest mistakes people make when picking a Medicare Plan. With this information in hand, you can ensure you make the best choice for you and your family.

View Medicare Advantage plans in your area

See Medicare Plans where you live.

1) Choosing the Wrong Plan

Choosing the right Medicare plan is a crucial decision that can greatly impact your healthcare coverage and costs. However, one of the biggest mistakes people make is choosing the wrong plan. With so many Medicare options available, it can be overwhelming and confusing to select the plan that best suits your needs.

One common error is simply selecting the plan with the lowest premium without considering other factors. While a low premium may seem appealing at first, it's important to evaluate the plan's coverage and benefits. Does it cover the specific healthcare services you need? Are your preferred doctors and hospitals in-network? Will it cover your prescription drugs? These are all important questions to consider when picking a Medicare plan.

Another mistake is not considering your future healthcare needs. While you may be relatively healthy now, it's essential to think ahead and anticipate any potential health issues that may arise in the future. Choosing a plan that offers comprehensive coverage and flexibility can help ensure that you are prepared for any unexpected medical expenses.

To avoid choosing the wrong plan, take the time to research and compare different Medicare options. Utilize online resources, speak with Medicare experts, and consider seeking advice from trusted healthcare professionals. By thoroughly evaluating your healthcare needs and weighing the pros and cons of each plan, you can make an informed decision that provides you with the best possible coverage and peace of mind.

2) Failing to Review Prescription Drug Coverage

One of the most common mistakes people make when choosing a Medicare plan is failing to review prescription drug coverage. Prescription medications can be a significant expense, especially for individuals with chronic conditions or multiple prescriptions. It's crucial to carefully review and consider how a plan covers your specific medications before making a decision.

Many people assume that all Medicare plans offer the same coverage for prescription drugs, but this is not the case. Medicare Part D is the prescription drug coverage portion of Medicare, and it is offered through private insurance companies. Each plan has its own formulary, which is a list of covered medications. These formularies can vary widely, so it's essential to review each plan's formulary to ensure your medications are covered.

Another important consideration is the plan's drug tiers. Prescription drugs are often divided into different tiers, with each tier having a different cost-sharing arrangement. Lower-tier drugs typically have lower copayments, while higher-tier drugs can be more expensive. Reviewing the drug tiers of each plan can help you understand the potential costs of your medications.

In addition to coverage and tiers, it's also important to consider the plan's preferred pharmacy network. Some plans have preferred pharmacies where you can get your medications at a lower cost. If you have a preferred pharmacy or a specific pharmacy you like to use, make sure it is included in the plan's network.

View Medicare Advantage plans in your area

See Medicare Plans where you live.

3) Not Considering the Total Cost of Care

When selecting a Medicare plan, many people focus solely on the monthly premium and fail to consider the total cost of care. This is a major mistake that can lead to unexpected expenses and financial strain. It's important to remember that Medicare plans have more than just a monthly premium. There are also deductibles, copayments, and coinsurance that you may be responsible for paying.

To fully understand the total cost of care, take the time to review and compare the out-of-pocket costs of different Medicare options. Look at each plan's deductible and copayment structure to get a clear picture of how much you may have to pay for various services and treatments. Additionally, consider the potential cost of your prescription medications. Remember that different plans may have different copayments or coinsurance rates for medications, so it's essential to review the details.

Don't forget to consider your healthcare needs and frequency of medical services when assessing the total cost of care. If you require frequent doctor visits or treatments, a plan with lower copayments or coinsurance may be more cost-effective in the long run, even if it has a higher monthly premium. On the other hand, if you have minimal healthcare needs, a plan with a lower premium and higher out-of-pocket costs may be a better fit.

By carefully considering the total cost of care, you can make a more informed decision about which Medicare plan is right for you. Remember, it's not just about the monthly premium - take into account the potential out-of-pocket costs, deductibles, copayments, and coinsurance. Don't make the mistake of overlooking this important aspect of selecting a Medicare plan. Take the time to evaluate all aspects of the plan and choose the one that provides the best overall value and coverage for your healthcare needs.

4) Ignoring Provider Networks

When it comes to choosing a Medicare plan, one of the biggest mistakes people make is ignoring provider networks. It's easy to overlook this crucial aspect, but it can have a significant impact on your healthcare experience and costs.

Provider networks are the list of doctors, hospitals, and other healthcare providers that a plan has contracts with. When you choose a plan, it's essential to ensure that your preferred healthcare providers are in-network. If they're not, you may end up paying higher out-of-pocket costs or even be responsible for the full cost of the services.

By ignoring provider networks, you may also miss out on the opportunity to receive care from highly skilled and experienced providers who specialize in your specific health conditions. In-network providers are chosen by the plan for their quality and cost-effectiveness, so by staying within the network, you can have peace of mind knowing that you're receiving quality care.

To avoid this mistake, take the time to review the provider networks of different Medicare plans. You can typically find this information on the plan's website or by contacting their customer service. Make a list of your preferred doctors, specialists, and hospitals, and check if they are included in the network of the plans you're considering.

Additionally, don't forget to consider any future healthcare needs or potential changes in providers. If you have a chronic condition that requires specialized care, ensure that there are in-network providers available who can meet your ongoing healthcare needs.

5) Waiting Too Long to Enroll or Make Changes

One of the biggest mistakes people make when selecting a Medicare plan is waiting too long to enroll or make changes. Many people put off making a decision until the last minute, thinking they have plenty of time or that it won't make a difference. However, this can have serious consequences and limit your options.

Enrolling in Medicare at the right time is crucial to avoid penalties and gaps in coverage. The Initial Enrollment Period (IEP) for Medicare is a seven-month period that begins three months before your 65th birthday month and ends three months after. It's important to enroll during this time to avoid any delays or gaps in coverage. Waiting too long to enroll can result in higher premiums and missed opportunities for coverage.

Another common mistake is not reviewing and making changes to your Medicare plan during the Annual Enrollment Period (AEP), which takes place from October 15th to December 7th each year. This is the time when you can make changes to your plan, switch to a different Medicare Advantage plan, or add or drop prescription drug coverage. Failing to review and make changes during this period could mean you're stuck with a plan that no longer meets your needs.

To avoid these mistakes, mark your calendar and make sure you enroll in Medicare or make any necessary changes during the appropriate enrollment periods. Don't wait until the last minute and risk facing penalties or gaps in coverage. Take the time to evaluate your options and make any necessary changes during the Annual Enrollment Period to ensure you have the best possible coverage for your healthcare needs.

Remember, Medicare is a complex system, and making mistakes when enrolling or making changes can have lasting consequences. By being proactive and taking advantage of the enrollment periods, you can avoid penalties, ensure continuous coverage, and have peace of mind knowing that you have the best Medicare plan for your situation. Don't wait too long – act now to make sure you're making the most of your Medicare options.

Get a Free Medicare Plan Comparison

Connect with a licensed agent

Get Help

Compare Medicare coverage options with the help of one of our agents:

Talk to us: (833) 265-9655 

Understanding Medicare Health Plan Costs

So, when it comes to understanding health plan costs, there are a few things you should keep in mind. Your costs can vary based on factors like the plan you choose and the services you receive. If you’re interested in a specific plan, you can get detailed cost information for that plan.   First off,

Read More

Medicare Login: Seamlessly Access and Manage Your Account

A Comprehensive Guide to Medicare Login: How to Access Your Personal Medicare Account   Are you a Medicare beneficiary looking to conveniently manage your healthcare information and benefits online? The Medicare login portal provides a user-friendly platform that allows you to access your personal Medicare account with ease. By logging in, you can view important

Read More

The Pros and Cons of Medicare Plan G

Medicare Plan G stands out as the most comprehensive Medigap option for individuals who enrolled in Medicare on or after January 1, 2020 Understanding the Pros and Cons of Medicare Plan G: A Comprehensive Guide   As individuals approach the age of 65, planning for medical expenses becomes a paramount concern. Medicare, a federal health

Read More

Comprehensive Guide to Medicare Insurance

Understanding Supplement, Advantage, and More Are you looking for reliable information on Medicare insurance options to make informed decisions about your healthcare coverage? Lehigh Partners is here to provide you with a comprehensive guide to Medicare insurance, covering a wide range of options to meet your specific needs. Medicare Supplement Insurance: Bridging the Gap Medicare

Read More

Finding the Best Medicare Insurance Near Me

Understanding Supplement vs. Advantage Plans Near You In today’s dynamic healthcare landscape, choosing the right Medicare insurance plan is crucial to ensure comprehensive coverage that meets your unique needs. With options like Medicare supplement and Medicare Advantage plans available, navigating the complexities of Medicare can be overwhelming. Understanding the differences between these plans and finding

Read More

Medicare and Transportation Services

Ambulances play a crucial role in transporting patients to and from medical facilities, such as hospitals. These vehicles are equipped with essential medical equipment and are staffed by highly trained professionals like Emergency Medical Technicians (EMTs) or paramedics. It’s important to understand how Medicare covers transportation in ambulances, especially during emergencies. Medicare Part B Coverage

Read More

Medicare brokers such as Lehigh Partners get paid by the insurance companies they represent. And you pay exactly the same rate for your insurance if you use a Medicare consultant (broker). There is no extra fee or cost for enrolling through a broker. You will never pay a fee for our help.


Find a Plan

Shop for coverage online. Safe, Secure, & Confidential

Call us

Call Lehigh Partners at 1-833-265-9655

Licensed insurance agents are available to help you through enrollment and beyond.

Need Help?

Get in touch with a licensed sales agent now by filling out the form - no obligations!

Get Our FREE Medicare Checklist.

Download our complimentary Medicare checklist and conveniently access all the necessary information in one place, ensuring you never miss a crucial number, deadline, or date again.

Tags

Medicare Advantage


Senior Medicare Advisors: Understanding the Role of Senior Healthcare Advisors

As the population ages, there is an increasing need for specialized healthcare services catered towards seniors. Medicare, a federal health insurance program primarily designed for individuals aged 65 and above, plays a crucial role in providing affordable healthcare coverage. However, navigating through the complexities of Medicare can be overwhelming for seniors. This is where Senior

Read More

Does Medicare Cover Wheelchair Ramps?

Medicare, as a federal health insurance program in the United States, provides coverage for various medical expenses. However, when it comes to durable medical equipment, such as wheelchair ramps, the coverage might not always be straightforward. This article will explore the extent to which Medicare covers wheelchair ramps, taking into account the necessary criteria, limitations,

Read More

How to switch from Original Medicare to Medicare Advantage

Enrollment in Medicare Advantage has seen a significant increase of over 100% in the past decade.1. One of the driving factors behind this is the availability of plans with premiums as low as $0, that provide coverage for prescription drugs, dental, vision, and hearing care – all of which are not covered by Original Medicare.

Read More

What is the Medicare Flex Card for Seniors?

A Medicare flex card helps cover health-related expenses like OTC medicine, dental copays, and more. It’s not related to original Medicare. The prepaid debit card, known as the Medicare flex card, is actually issued by Medicare Advantage plans and not the U.S. government. It is available through select private Medicare Advantage plans as a means

Read More

5 Myths About Medicare Advantage – Exposed!

Beware of these common misconceptions and stay informed during Medicare’s Annual Enrollment Period. Don’t let misinformation misguide you! Debunking Medicare Advantage myths and clarifying the facts for informed choices. It’s likely that you’ve been gathering Medicare advice from various sources such as relatives, neighbors, and even strangers in the doctor’s waiting room. One friend may

Read More

Medicare Part A Deductible and How It Works

Medicare Part A is a part of Original Medicare that primarily covers inpatient hospital care, skilled nursing facility care, hospice care, and home health care. As with most insurance plans, Medicare Part A has certain deductibles and copayments that beneficiaries are responsible for paying before Medicare coverage kicks in. In this article, we will focus

Read More

Unpacking Medicare Advantage (Part C): Could an Advantage plan be right for you?

Medicare Advantage (part C) is a convenient way of managing healthcare costs as it allows you to get everything you need under one roof. These plans are provided by private insurance companies approved by Medicare and referred to as Medicare Part C. Essentially, every Medicare Advantage plan includes coverage for everything that Original Medicare (Parts A

Read More

Ready to talk to an agent about your Medicare coverage?