Enrolling in Medicare is like a big meal with a lot of starters. Before you place your order, choose between Original Medicare and Medicare Advantage.
The original Medicare plan is divided into two parts: Medicare Parts B, C, and D. Next, you choose from Medigap plans A, B D, G K L M N.
The options are still overwhelming if you choose the Medicare Advantage menu. You’ll receive a special blue plate that bundles together coverage for Parts A and B. Ohio residents, for instance, have 216 Medicare plans to choose from, offered by 20 different insurers.
Given the complexity of the health insurance system, first-time enrollees often feel overwhelmed. At least in their minds. They don’t even know how to answer the question that is at the heart of the matter: “How can I ensure 5 star care throughout my life?”
Avoiding a few fundamentally poor choices can be costly, or even impossible.
How much can you expect to pay for your medical care under Medicare? A measure of this is how many Medicare-eligible people are in serious debt because they have to pay for their health care. According to KFF’s 2022 survey, 22% of those aged 65 or older said that they had unpaid medical and dental bills.
We’ll dig into the details to show you how to prevent these big mistakes.
1. Enroll early, even if your current needs for health insurance are minimal
Medicare Part B is your insurance for outpatient care, doctor’s bills and other services. The Centers for Medicare & Medicaid services average late enrollment penalty for Part B was 27% more than the base rate in 2022. This penalty was $45.93 per monthly. You pay the Part B penalty every month for as long that you are on Medicare. The amount is proportional with how long you waited to enroll.
You may delay enrolling in Medicare Part D if you only take generic drugs. However, it’s likely that you will need to purchase more expensive medication at some point.
Sarah Murdoch is the director of Client Services at Medicare Rights Center. This nonprofit organization advocates for consumers. Some Part D plans can be very affordable .”
You may save money now if you don’t enroll in Part A, B, or D, but when penalties are applied, you could end up paying more. Most retirees can’t realistically expect to see their income grow.
2. Original Medicare doesn’t cover Medigap.
Charles Weeks of Barrister Wealth Management, Philadelphia says: “It is shocking to see how few people know that they require a Medigap policy “>,”. According to a KFF analysis, approximately 6,000,000 people have Original Medicare but do not have Medigap.
Weeks says that “the issue is they don’t know that Part B covers only 80%” of outpatient services, such as doctor appointments, chemotherapy or joint replacement surgeries. These can cost tens and thousands of dollars. Medigap could leave you paying 20% or more of large medical bills. Medicare Part B does not have a cap on the amount you pay.
You should be aware that in the majority of states residents 65 years and older are not guaranteed to enroll in Medigap insurance, despite any pre-existing medical conditions. This guarantee expires 6 months after enrolling for Medicare.
3. If you switch from Original Medicare to Medigap, you may not be eligible for Medigap.
Do not sign up for Medicare Advantage initially, which is free or very cheap. Then switch to Original Medicare when you require extensive medical treatment.
Tricia Neuman is a senior Vice President at KFF. She says, “It is true that people who sign up for Medicare Advantage plans can later switch over to Original Medicare.” It’s a little-known fact that Medicare Advantage plan holders may not be eligible to purchase a Medigap insurance policy. My friends have learned this lesson the hard way .”
This is a troubling situation: A Medicare beneficiary gets a severe illness diagnosis that requires expensive outpatient care.
The beneficiary will switch to Original Medicare to gain access to doctors outside of their Medicare Advantage Network. Insurers in many states can evaluate the health of beneficiaries who want to purchase a Medigap plan to pay for Part B’s coinsurance cost (20%) and deny them coverage, or charge an exorbitant premium.
If you ever think that you will need Medigap insurance, you should choose this option during the initial enrollment.
4. You shouldn’t expect unbiased, comprehensive advice from your insurance agent.
The interests of insurance agents may not always coincide with yours, while friends who are close to you might be unaware of the complexity and nuances that apply in your case. Before enrolling in Medicare, you should seek the advice of a specialist whose sole purpose is to guide you through your choices.
The Medicare Rights Center Helpline is available to answer questions for people from all 50 states. Neuman claims that the State Health Insurance Assistance Program, which is a link to all of the state’s health insurance assistance program programs, provides “neutral information”.