1) Misunderstanding Enrollment Periods

You may have heard about Open Enrollment, which occurs every year from October 15th to December 7th, and you may have thought that this is when your opportunity to enroll into Medicare is.  Not true!  Open Enrollment is for beneficiaries already in the program who are looking to change their plan coverage for the upcoming year.   

• If you are coming into Medicare for the first time you get your own enrollment period.  It is referred to as an IEP, or Initial Enrollment Period.  
• This period is the 3 months before your 65th birthday, your birth month, and the 3 months following your birth month.  
• If you miss your initial personal deadline because you are waiting for Open Enrollment (and if you do not have Creditable Coverage through an employer or your spouse's employer) you are risking delayed coverage and permanent late penalties.  

(There are different enrollment periods that apply to different situations as well- such as those who qualify for Medicare because of a disability, or those who have a special circumstance and so they are able to sign up during a Special Enrollment Period)

2) Misunderstanding the Parts of Medicare

Part A helps pay for hospital stays, skilled nursing facilities, home health services and hospice care as long as certain conditions are met.  If you or your spouse have worked and paid taxes to Medicare for at least 40 quarters (10 years) Part A will be free.  If you do not have enough working quarters, Part A will have a premium you will be required to pay.  

Part B helps to pay for doctor’s services both in and out of the hospital, outpatient care such as lab work and screenings, as well as some medical supplies and equipment such as oxygen and wheelchairs if certain conditions are met.  There is a premium for Part B. Medicare will typically pay 80% of the Medicare approved cost, and you will pay 20%, unless you have a supplemental insurance policy that helps to cover these out of pocket expenses.  

Part C provides an alternate way to receive Medicare services through Medicare Advantage plans, which are administered through privately managed plans such as HMO’s or PPO’s. These plans are required to cover all of the same services as Original Medicare (Part A and B), but they may charge lower co-pays.  Also, at the plan’s discretion, they may offer Part D drug coverage, as well as some extras like routine vision and hearing care.   You may pay a monthly premium for a Medicare Advantage plan, in addition to your Part B premium.  However some MA plans do not charge premiums of their own. (Medicare Advantage plans may restrict your choice of doctors and other providers, and charge higher co-pays if you receive care out of network). Senior Care of Texas and its representatives will NEVER SELL a Medicare Advantage plan.

Part D helps to pay for prescription medications that you may use at home. This coverage can come in one of two ways, by joining a private stand alone Part D drug plan and paying an additional monthly premium OR by enrolling in a MA plan that includes Part D coverage in its benefit package.  

3) Not Checking to See If You Qualify for Special Help to Lower Your Medicare Costs.  

Medicare can come with many different expenses in regards to premiums, co-pays and deductibles that many might struggle to pay.  If your income is limited there are programs that can help reduce those costs.

4) Failing to Read Your Plans Annual Notice of Change.  

If you are currently enrolled in a Medicare Advantage Plan, or a Part D prescription drug plan, your provider will send you this important notice in the mail every September.  You will want to make sure that you read this document over carefully as it will list any plan changes in regards to coverage and costs for the next year.  Failing to read this notice can result in surprises to you in the upcoming year if you are unaware of any cost and coverage changes.  

It is good to keep up on this because if your plan is making changes that you do not agree with, you will have the opportunity to compare plans and switch during Open Enrollment (October 15th to December 7th) if you choose.  

 

5) Making Sure to Ask Questions if There is Something You Don’t Understand in Regards to Medicare.

We are sure you have heard the adage “there is no such thing as a dumb question” and that is the truth!  Every one of us will find ourselves in the position of being new to Medicare in our lifetime and it can sure be overwhelming!  That is why it is important to speak with someone you can trust if you are having a difficult time understanding or making these often times difficult Medicare decisions.  

There are many different plans and options out there and it is good to have someone who can help you do your homework when it comes to choosing something that will not only be what you need in regards to your health, but also in regards to your finances.  

Is it important to you that you transition into Medicare with a company you can trust? We believe that we are that company.  We believe that we are a trusted source of information for Medicare beneficiaries. We have an A+ rating with the Better Business Bureau and we have received the Pinnacle Award, the highest award granted to those who excel in customer service.  If you need assistance with your Medicare journey, we invite you to give one of our trusted agents a call.  It would be our pleasure to help walk you through this process!