Whether you are already enrolled in Medicare or looking ahead, it is important to understand what Medicare covers and when to enroll. From missing enrollment windows to selecting a prescription plan not suited to your needs, Medicare mistakes can be costly.
Know your window
There is a seven-month window for Medicare enrollment that begins three months before your birth month and ends three months after your birth month. If you do not enroll when you were first eligible, you can enroll during the annual Medicare Open Enrollment period (October 15 – December 7), but a late penalty may apply.1,2
Unlike Medicare Parts A (hospital insurance) and B (medical insurance), enrolling in a Part D (prescription insurance) plan is optional. But there’s a catch. With a few exceptions (e.g., employer coverage), if you do not enroll when you first become eligible, a lifetime penalty will be added to your premium when you do enroll.2,3
Even seniors with insurance coverage from an employer before or after retirement need to be mindful of enrollment requirements. For example, did you know that your employer may be able to designate Medicare as your primary insurance when you turn 65?3 Depending on the size of your employer, Medicare may require you to sign up during the Initial Enrollment Period based on your birthday, not retirement, and not doing so could result in late penalties.2,3
If you are nearing 65, knowing when you need to enroll could save you big – just when you need it most.
Selecting your prescription coverage
With fixed incomes and the increasing medical needs that come as we age, prescription costs can be a major stressor for many seniors. But with as many as 30 plans to consider, selecting the right Medicare Part D plan can be overwhelming.3
Enrolling in the plan with the lowest premium may seem like the obvious answer, but not considering all factors can cost you in the end. Make sure the plan you choose meets your priorities:
- Are you currently taking medications?
- Look for plans that include your medications in their formulary.
- Do you want extra protection from high prescription drug costs?
- Look for plans that will offer you coverage in the coverage gap.
- Do you want drug expenses to be balanced throughout the year?
- Look for plans with a low or no deductible or with additional gap coverage.
- Do you take a lot of generic prescriptions?
- Look for a plan that offers low or no copayments on generics.
- Do you not have many drug costs now but want peace of mind and to avoid future penalties?
- Look for a plan with a low monthly premium.
- Do you prefer the extra benefits and lower costs available by getting your health care and prescription drug coverage from one plan (and are willing to accept the plan’s restrictions on what doctors, hospitals, and other health care providers you can use)?
- Look for a Medicare Advantage Plan (Part C) that includes prescription coverage. Part C is available through private insurance companies that contract with Medicare.5
Navigating your choices
Medicare.gov, the official U.S. government site for Medicare, can help you select the coverage that best suits your needs. For your Part D plan, the site’s Medicare Plan Finder can help choose and enroll in a plan based on your needs and current medications (hint: have your prescription list handy!)
Plan options change year-to-year, as do your needs. Be sure to reevaluate your coverage annually so that you can change plans during Open Enrollment if there is a better option. It could save you hundreds – or even thousands – of dollars.
We’re here to help
We know that selecting a Medicare Part D plan can be intimidating. If you are unsure if your current plan is the best one for you or need advice about selecting a new plan for 2020, talk to your Health Mart pharmacist.
Health Mart. Caring for you and about you.
Nothing herein constitutes medical advice, diagnosis or treatment, or is a substitute for professional advice. You should always seek the advice of your physician or other medical professional if you have questions or concerns about a medical condition.
- AARP: How to Avoid These Common Medicare Mistakes https://www.aarp.org/health/medicare-insurance/info-2019/common-medicare-mistakes.html Last accessed: July 18, 2019
- Very Well Health: The Top 6 Mistakes Seniors Make When It Comes to Medicare Enrollment https://www.verywellhealth.com/top-mistakes-seniors-make-with-medicare-enrollment-2318676 Last accessed: July 18, 2019
- CNBC: Here’s how to avoid costly Medicare mistakes when retiring after age 65 https://www.cnbc.com/2019/07/19/avoiding-costly-medicare-mistakes-when-retiring-past-age-65.html July 19, 2019
- Henry J. Kaiser Family Foundation: An Overview of the Medicare Part D Prescription Drug Benefit https://www.kff.org/medicare/fact-sheet/an-overview-of-the-medicare-part-d-prescription-drug-benefit/ Last accessed: July 18, 2019
- Medicare.gov: 6 things to look for when choosing Medicare drug coverage https://www.medicare.gov/drug-coverage-part-d/how-to-get-drug-coverage/6-things-to-look-for-when-choosing-medicare-drug-coverage Last accessed: July 18, 2019
Posted on Thu, August 1, 2019
by Health Mart