Pitfalls to Avoid when Choosing the Right Medicare Insurance Plan

Shopping for the right Medicare insurance plan is a daunting task. There are so many choices available, that researching Medicare plans can seem overwhelming. How do you know which option is right for you and your family? Are you choosing the right plan? Where do you begin?

At the Levine Benjamin Law Firm, we’ve done the Medicare research for you. We’ve advised thousands of Social Security Disability recipients on Medicare insurance options, and we’re here to help you, too. Read along for the top pitfalls to avoid when choosing the right Medicare insurance plan.

Make Sure You Know the Basics

First things first, it’s important to know the basics of Medicare so you can navigate through selecting a plan. Medicare is a government-funded health insurance plan for people age 65 and older, people of any age who receive Social Security Disability (SSD) benefits, and people living with End-Stage Renal Disease (ESRD).

Medicare is available in Parts. First up there’s “Original Medicare.” Original Medicare includes Medicare Part A — which provides hospital insurance and covers inpatient hospital care, skilled nursing facilities, hospice and home health care. Original Medicare also includes Medicare Part B — which is medical insurance that covers services from doctors and other health care providers, preventative services, hospital outpatient care, durable medical equipment and home health care.

Medicare Part A is required, while Medicare Part B is optional. But, don’t skip Medicare Part B coverage just to save yourself a dime. If you don’t enroll when you are first eligible but choose to enroll later, you’ll be hit with high late-enrollment fees for life.

Choose A Plan That Will Cover All Your Needs

Many people who have Original Medicare choose to get a Medigap policy. These policies, which are provided by private insurance companies that are approved by Medicare, offer supplemental insurance. Medigap policies pay for things that Medicare Parts A and B don’t pay for, such as copayments, coinsurance and deductibles.

While Medigap policies do charge a monthly premium, skipping supplemental insurance all together could result in you paying high out of pocket expenses. So, make sure to evaluate the full financial impact of a plan before choosing whether or not to go with Medigap coverage.

Know That You Have Options

Rather than choosing Original Medicare and a Medigap policy, some people choose Medicare Part C, also called Medicare Advantage. This alternative to Original Medicare includes all the benefits of Medicare Part A and Medicare Part B, but is instead run by a Medicare-approved private insurance company. Many Medicare Advantage plans also include prescription drug coverage and other services for an additional fee.

Don’t Skip Prescription Drug Coverage

Medicare Part D, which is Medicare Prescription Drug Coverage, is run by private insurance companies that are approved by Medicare. If you’re healthy and don’t take daily medications, it may seem tempting to skip Medicare Part D. But that could be a costly mistake. With Medicare, everyone is required to have prescription drug coverage, either through a Medicare Part D plan, a Medicare Advantage Plan, or a creditable drug coverage plan from an employer or trade union that pays at least as much as Medicare does. If you don’t enroll for prescription drug coverage when you are first eligible, you’ll be hit with costly late-enrollment fees.

Sign Up Before You Turn 65

If you’re still working and have health insurance through your employer, you may think you don’t need Medicare. But, don’t be so certain. All Americans age 65 and older are required to be on Medicare. Not enrolling when you are first eligible can result in you paying high late-enrollment penalties for life. The only way out of enrolling for Medicare is if you are enrolled in an employer-sponsored group health plan, and your employer employs 20 or more people.

Be Wary of Hidden Fees on Zero and Low-Cost Premium Medicare Advantage Plans

Those who’ve decided to go with Medicare Advantage are often pleasantly surprised to see that there are zero-dollar and low-cost premium plans available. Medicare coverage with little to no monthly fees? Sounds great!

But, keep in mind that there are other fees to consider. A Medicare Advantage plan with no monthly premium could have high out of pocket costs, including high deductibles, coinsurance and copayment rates. Oftentimes it makes more sense to go with a moderately-priced monthly premium plan that has lower usage fees, especially if you anticipate needing to use your coverage to manage a health condition.

Reach Out For Help

Signing up for Medicare is a confusing process, but you don’t have to go through it alone. Contact an experienced Medicare Advisor, like the ones at the Levine Benjamin Law Firm, for help navigating the ins and outs of Medicare.