Every year, thousands of Arizona seniors make avoidable mistakes during Medicare enrollment that end up costing them real money. Some of these mistakes lead to late penalties that follow you for life. Others leave you stuck in a plan that does not cover your doctors or your medications.
After 7 years of helping seniors across the East Valley navigate Medicare, I have seen every mistake in the book. Here are the five most common ones and how to avoid them.
1. Missing Your Initial Enrollment Period
Your Initial Enrollment Period (IEP) is a 7-month window around your 65th birthday: 3 months before, your birthday month, and 3 months after. If you miss this window and do not have qualifying coverage through an employer, you could face late enrollment penalties on Part B and Part D that increase your premiums permanently.
The Part B late penalty is 10 percent of the standard premium for every 12-month period you were eligible but did not enroll. That adds up fast and it never goes away.
2. Assuming Your Employer Coverage Is Enough
If you are still working at 65 and have employer coverage, you may be able to delay Medicare without penalty. But this only applies if your employer has 20 or more employees. If your employer has fewer than 20 employees, Medicare becomes your primary insurance at 65, and delaying enrollment could leave you with coverage gaps and penalties.
Always verify your employer’s size and how their plan coordinates with Medicare before making assumptions.
3. Choosing a Plan Based on Premium Alone
A zero-dollar premium Medicare Advantage plan sounds great until you realize your cardiologist is out of network or your prescriptions are on Tier 4. The cheapest plan is rarely the best plan.
Before enrolling in any plan, check three things: Are your doctors in network? Are your medications covered at a reasonable cost? Does the plan cover the services you actually use?
4. Forgetting to Review Your Plan Every Year
Medicare plans change every January 1st. Carriers adjust their formularies, drop providers from networks, and change copay structures. A plan that was perfect last year might cost you hundreds more this year.
During the Annual Enrollment Period (October 15 through December 7), you should review your current plan and compare it to what else is available. This is something I do for all of my clients every fall.
5. Not Working With a Local Broker
Many people either go directly to Medicare.gov or call a 1-800 number they saw on TV. The problem is that these options cannot give you personalized advice. A licensed broker who knows your area can check your specific doctors, review your prescriptions, and compare every plan available in your zip code, all at no cost to you.
Brokers are paid by the insurance companies, not by you. The premium is the same whether you enroll on your own or through a broker. The only difference is you get a real person who will help you make the right choice and be there if you need help later.
Avoid the Mistakes: Get Free Help
If you are approaching 65, already on Medicare, or helping a parent with their coverage, I am happy to walk you through your options. I am based in Mesa, Arizona and I work with seniors across the East Valley every day.
Call me at 480-296-5804 or request a free plan review and I will call you back.