The Doctor Will See You Now – 5 Medicare Mistakes That Could Cost You

By Optum New Mexico

For those on Medicare or who are becoming eligible, the Medicare Annual Enrollment Period (AEP), from October 15 to December 7, is the best time to evaluate or adjust your plan. During AEP, you can enroll, re-evaluate, or change plans for Original Medicare, drug coverage, or Medicare Advantage.

Those eligible for Medicare include people ages 65 and older, people younger than 65 with Social Security Disability Insurance (SSDI), or those with End-Stage Renal Disease (ESRD).

While managing your Medicare decisions, be sure to avoid making these potentially cost mistakes:

1. Don’t let automatic renewal decide for you.
   Medicare Part D and Medicare Advantage plans renew annually on January 1 unless changed. However, automatic renewal might not serve you well if your health needs or financial situation has changed. Plans can also adjust what they cover year-to-year, including premiums, deductibles, or copays, which will be detailed in your Annual Notice of Change.
2. Don’t ignore the Annual Notice of Change (ANOC).
   The ANOC, typically sent by September 30, informs you of changes in plan benefits and costs for the coming year. These changes may impact your health care or budget. Reading this letter helps you decide whether to stick with your current plan or explore new options during AEP.
3. Don’t focus on premiums alone.
   A plan with a low premium may seem appealing, but it could lead to high out-of-pocket costs, especially if you frequently use health care services. It’s important to consider the overall costs, including deductibles and copays, and any extra benefits, like dental or vision coverage. Assess your health needs to ensure your plan meets them.
4. Don’t choose a plan based on someone else’s recommendation.
   Medicare plans are personal, and what works for one person may not work for you. Consider your unique health care needs, budget, and preferences when choosing a plan. Medicare.gov suggests evaluating seven factors: cost, coverage, additional insurance, prescription drugs, doctor and hospital choice, care quality, and travel coverage.
5. Don’t assume you don’t qualify for financial help.
   Several programs assist with Medicare costs, including Medicare Savings Programs, which can cover premiums, deductibles, and copays if you meet certain conditions. Programs like Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualifying Individual (QI) may also offer extra help with prescription drug costs. It’s worth exploring these options even if you think you may not qualify.

For more details, visit www.medicare.gov or call 1-800-MEDICARE. You can also contact your State Health Insurance Assistance Program office at www.shiphelp.org.