Enrolling in Medicare is a significant milestone, one that should mark the beginning of a secure and healthy retirement. Yet, the path to the right coverage is often filled with confusing rules, complex choices, and costly pitfalls.
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Choosing your Medicare coverage is one of the most important financial and health decisions you will make. By understanding the most common errors, you can navigate the process confidently and select a plan that truly protects both your health and your savings.
Why Medicare Decisions Are So Easy to Get Wrong
If you feel overwhelmed by Medicare, you are not alone. The system is a complex mix of government-run programs (Parts A and B) and private insurance options (Part D, Medicare Advantage, and Medigap). With different enrollment windows, cost structures, and rules, it is easy to make a simple mistake that could cost you thousands of dollars or limit your access to care when you need it most.
Mistake 1: Missing Important Enrollment Deadlines
This is perhaps the most critical error. Your Initial Enrollment Period (IEP) is your first and best chance to sign up. If you miss it and do not qualify for a Special Enrollment Period (such as still working with employer coverage), you may face lifelong late enrollment penalties.
The Part B penalty, for example, is added to your monthly premium forever. In 2022, nearly 750,000 beneficiaries were paying this penalty, with an average increase of 27 percent to their premium. Missing your Part D enrollment can also result in a permanent penalty.
Understanding these dates is essential. You can learn more in our guide, Your Guide to Medicare Enrollment Periods: When to Sign Up.
Mistake 2: Focusing Only on the Monthly Premium
It is tempting to choose a plan with a $0 or very low monthly premium. This is a common feature of many Medicare Advantage plans. However, a low premium often means higher out-of-pocket costs when you actually use your benefits.
A plan with a higher premium, such as a Medicare Supplement plan, may save you thousands of dollars in the long run by covering your deductibles and coinsurance. The true cost of a plan is not its premium, but what you will pay for the entire year, including all medical care.
Mistake 3: Assuming Original Medicare Covers Everything
Original Medicare (Parts A and B) provides a strong foundation, but it was never designed to cover 100 percent of your medical bills. It leaves significant “gaps” that you are responsible for.
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The most notable gap is the 20 percent coinsurance on Part B services. This has no annual cap, meaning a serious illness or surgery could leave you responsible for thousands of dollars. As we detail in our article What Medicare Doesn’t Cover: Common Surprises, these gaps are precisely why Medicare Supplement (Medigap) plans exist: to fill those gaps and provide predictable costs.
Mistake 4: Ignoring Prescription Drug Coverage (Part D)
Even if you do not take many prescriptions now, you should not skip enrolling in a Part D drug plan when you are first eligible. As mentioned, failing to enroll can trigger a permanent late enrollment penalty if you decide you need a plan later. Furthermore, a sudden health issue could leave you facing the full, high cost of necessary medications without coverage.
Mistake 5: Not Comparing Medicare Advantage and Medigap Plans
These two options work in completely different ways. A Medicare Advantage (Part C) plan is an alternative to your Original Medicare. A Medigap (Medicare Supplement) plan works with your Original Medicare.
Each has its own structure of costs, rules, and benefits. For a detailed comparison, see our article The Essentials: Medicare Supplement vs. Medicare Advantage Explained. Simply picking one without understanding the other is a common mistake that can lead to buyer’s remorse.
Mistake 6: Not Checking Doctor and Hospital Networks
This mistake applies primarily to Medicare Advantage plans, which usually operate with restrictive HMO or PPO networks. If you enroll in one of these plans, your favorite doctor or preferred hospital may not be in the network, or you may need a referral to see a specialist.
This is a key area where Medicare Supplement plans offer superior value. With a Medigap plan, you have the freedom to see any doctor or visit any hospital in the United States that accepts Medicare.
Mistake 7: Forgetting to Reevaluate Coverage Every Year
This is a crucial step for anyone in a Medicare Advantage or Part D plan. These plans can and do change their benefits, provider networks, and drug formularies (the list of covered drugs) every single year. A plan that was a perfect fit this year could be a terrible choice next year.
Medicare Supplement plans, by contrast, are standardized. Their benefits do not change from year to year, providing a much more stable and predictable coverage experience.
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Mistake 8: Not Understanding Medigap Underwriting Rules
While Medigap plans offer incredible freedom, there is a critical rule for enrollment. When you are first eligible (in your 6-month Medigap Open Enrollment Period), you have “guaranteed-issue rights.” This means an insurance company cannot use your health history to deny you a policy or charge you more.
If you wait and try to buy a Medigap plan later, you will likely have to go through medical underwriting and can be denied coverage for pre-existing conditions.
Mistake 9: Overlooking Travel or Out-of-State Coverage
If you love to travel or live in two different states during the year (a “snowbird”), your plan’s network is a major factor. Most Medicare Advantage plans have regional networks, meaning your coverage may be limited to emergency care when you are out-of-state.
Medicare Supplement plans travel with you. Since they work with any provider that accepts Medicare nationwide, your coverage is just as good in Florida as it is in New York. You can learn more at Medicare for Snowbirds: What Seasonal Travelers Need to Know.
Mistake 10: Trying to Navigate It All Alone
Medicare is complicated, but you do not have to become an expert overnight. Trying to research all these options alone can lead to frustration and, worse, a poor coverage decision. The best choice is to seek help from a knowledgeable, independent resource.
A licensed insurance agent who specializes in Medicare can explain the pros and cons of each option as they apply to your specific situation, budget, and health needs. They can help you avoid these common mistakes and find a plan that provides true peace of mind.
