Medicare is the nation’s health care program for citizens
age 65 years and up, and it covers many major medical expenses for
participants. But choosing the right Medicare plan can be confusing in many
cases, and it may be difficult to decipher all of the language that is written
into these plans and options.
Here are some potential mistakes to avoid when you choose
your plan, so that you end up with the coverage that you need.
Not
enrolling during your enrollment window:
This can be one of the biggest mistakes that you can make
with Medicare. If you are receiving Social Security when you turn 65, then you
will be automatically enrolled and have the premiums deducted from your monthly
benefits. But if you have delayed taking Social Security until a later age,
then you will have to manually enroll when you turn 65. The enrollment period
begins three months before the month in which you turn 65 and lasts for three
months after that. You do not have to sign up if you are still covered under a
health insurance policy from your job. (COBRA coverage and coverage from a
former employer where you still pay the premiums don’t count for this.) Once
you quit working, you have eight months in which to sign up. And if you work
for a company with fewer than 20 employees, then you may be required to sign up
even if you have current coverage with the company. You can also delay signing
up if you have current coverage through a younger spouse’s plan. But failure to
sign up within the prescribed window can result in surcharges on your future
premiums and potential gaps in your coverage.
Assume your
spouse is covered:
Medicare coverage
applies only on an individual basis. Just because you have coverage does not
mean that your spouse is also covered. He or she also has to have paid his or
her dues in the workforce for at least 10 years in order to qualify for Part A.
If your spouse is not yet 65, then he or she will have to find coverage
elsewhere, such as with their employer or through COBRA or a policy that is
sold on the exchange. It does not matter whether your spouse is receiving
spousal Social Security benefits.
Not
purchasing enough coverage:
While Medicare Part A is free, Parts B, C and D all require
a monthly premium. Most people should probably get at least Part B, so that
they have coverage for doctor’s visits and outpatient care. The standard
premium of $121.80 can be deducted from your monthly Social Security benefit.
But Parts C and D can also provide important coverage for things like dental, vision
and prescription drugs. You can also opt for a Medicare Advantage policy that
helps to defray these costs. The average premium for this type of coverage will
run you about $32.60 in 2016. And a Medigap insurance policy can help you to
pay for things that are not covered elsewhere, like coinsurance, copays and
deductibles.
Not seeking
assistance if you can’t afford the premiums:
If your income is low
enough that you will have trouble affording the premiums, your state or local
department of social services may have programs available for those who
financially qualify.