There are numerous reasons why you should consider applying for Medicare in Texas, but the process can be confusing, time-consuming, and can easily be done incorrectly, leaving individuals who are 65 years or older or other individuals with disabilities without the coverage they need and deserve. To have access to various healthcare services, financial protection, coverage options, and more, enrolling in the Medicare program can protect your health and well-being, but ensuring it’s done correctly the first time around is crucial. Avoid these common mistakes that can lead to delays and extra costs.
Avoid These Common Medicare Enrollment Mistakes
You are eligible for Medicare when you turn 65 or if you have received certain Social Security Administration (SSA) disability benefits. Enrolling as soon as possible is recommended, but navigating the world of Medicare can be confusing for many. This is why we want to help you understand its basics, including how to avoid these common mistakes.
- Not Enrolling on Time
If you become eligible but do not enroll during your initial enrollment period (IEP), you can face penalties and delays in coverage. For example, if you’ll be turning 65 in August, your IEP begins three months before and ends three months after your birthday, so you have from May to November to apply. If you miss this period, you’ll still be able to enroll during Medicare’s annual enrollment period from January 1 – March 31 for Part B, but because you enrolled late, your premiums will be higher. Alternatively, if your health insurance with your employer has ended, you’ll qualify for a special enrollment period (SEP). You’ll need to sign up eight months before your coverage ends or eight months afterwards to avoid late penalty fees. Ultimately, timing is everything when it comes to enrolling!
- Choosing the Wrong Medicare Plan
There are different “parts” of Medicare. You should take your time to carefully review your options and choose the plan that best suits your needs and budget.
- Part A: Also known as hospital insurance which covers inpatient hospital stays, skilled nursing faculty care, hospice care, and some home health care.
- Part B: Also known as medical insurance which covers outpatient care, preventive services, medical supplies, and some home health care.
- Part C: Also known as Medicare Advantage. This allows beneficiaries to receive all of their Medicare benefits through a private insurance plan.
- Part D: is for prescription drug coverage.
- Not Updating Your Information
Not reviewing even the smallest details is one of the most common mistakes people make. Failing to update your personal information such as an address change, name change or income information, can lead to issues with your benefits or coverage, or not changing or renewing coverage every year during the annual enrollment period which runs from October 15 – December 7. Take the extra time to review everything to ensure your plan is still meeting your specific needs and budget and that all of your personal information is correct. Because circumstances can change so quickly, it’s not recommended to opt for auto renewal.
- Not Considering Other Aspects that Affect Coverage
Just remember that certain aspects of your care and finances can have a significant impact on your Medicare coverage. Medicare is a government-funded program designed to help seniors and individuals with disabilities access healthcare, however, higher-income individuals may be subject to higher deductibles and may not even qualify for certain forms of Medicare assistance. Those with pre-existing conditions may also face higher premiums or limited coverage options. You also need to consider whether your primary care physician or other specialist participates in the plan or if the plan covers your area. It’s also important to understand how Medicare coordinates payments with your employer’s health insurance coverage. If you don’t know how much is being covered by who, you could end up with unexpectedly high out-of-pocket costs.
- Not Paying Your Medicare Premiums
Unfortunately, if you miss a payment or pay late, your next bill will have a “past due amount”. Not paying will also result in you losing coverage. If you have trouble affording Medicare, there are options available to you such as Medicaid, Medicare Savings Program and Medicare Part D Extra Help. Again, it’s crucial to take the time to understand these programs and review everything carefully.
There are Many Benefits to Medicare
Medicare provides a wide range of benefits to residents of Texas, including access to affordable healthcare services for older adults, individuals with disabilities, and those with certain medical conditions. Medicare can cover the cost of essential services such as hospital stays, doctor visits, prescription medications, medical equipment, and more. It offers peace of mind to beneficiaries knowing that they have access to quality healthcare without worrying about financial barriers. Plus, it allows for individuals to choose the coverage that best fits their needs. However, getting your enrollment forms right the first time around is crucial to avoid costly mistakes. To ensure a smooth and hassle-free enrollment process, Wise Insurance offers guidance and is dedicated to making sure Texans have access to the healthcare they need to maintain their health and well-being.
Emily Trevino, Senior Managing Partner at Wise Insurance, leverages her extensive background in biology and business finance to master Medicare, health insurance, and retirement planning. With over a decade in the field, Emily has co-authored “Medicare Breakdown – The Alphabet Soup of Medicare,” marking her as a pivotal figure in insurance education. Her commitment extends through active participation in the National Association of Benefits and Insurance Professionals (NABIP) and speaking at major industry events. Emily’s drive for community service and personal resilience shines through her adventurous pursuits and dedication to societal well-being. Connect with Emily on LinkedIn to explore the future of informed insurance decisions.
