5 Medicare Mistakes That Cost Seniors Thousands of Dollars
After 17 years helping seniors navigate Medicare, I have seen the same costly mistakes over and over. Here is how to avoid every one of them.
5 Medicare Mistakes That Cost Seniors Thousands of Dollars
In 17 years of helping seniors navigate Medicare, I have seen the same mistakes come up again and again. Some of them are easy to fix. Others follow people for the rest of their lives in the form of permanent premium penalties.
Here are the five most costly Medicare mistakes -- and exactly how to avoid them.
Mistake #1: Missing Your Initial Enrollment Period
Your Initial Enrollment Period (IEP) is a 7-month window around your 65th birthday. Miss it without a qualifying reason, and you face:
- A 10% permanent Part B premium penalty for every 12 months you were eligible but did not enroll
- A 1% per month permanent Part D penalty for every month you went without creditable drug coverage
These penalties never go away. A 2-year delay means a 20% higher Part B premium for the rest of your life.
The fix: Mark your calendar 3 months before your 65th birthday and start the enrollment process. If you are still working and covered by employer insurance, call me to confirm whether you need to enroll now or can delay without penalty.
Mistake #2: Choosing a Plan Based on Premium Alone
A $0 premium Medicare Advantage plan sounds great -- until it does not cover your doctors, your hospital, or your medications.
I see this constantly. Someone picks the cheapest plan, then discovers their cardiologist is out of network, or their expensive specialty drug is not on the formulary, or the plan requires prior authorization for every specialist visit.
The fix: Always verify three things before enrolling in any plan:
- Are your doctors in-network?
- Are your medications on the formulary -- and at what tier?
- What is the out-of-pocket maximum?
A plan that costs $50/month more but covers your doctors and drugs will almost always save you money in the long run.
Mistake #3: Not Reviewing Your Plan Every Year
Medicare plans change every year. Premiums go up. Drug formularies change. Networks shrink. A plan that was perfect for you in 2024 may be a poor fit in 2026.
The Annual Enrollment Period (AEP) runs October 15 - December 7 every year. This is your chance to review your coverage and make changes that take effect January 1.
Most people never look at their plan again after they enroll. That is a mistake.
The fix: Every fall, review your plan's Annual Notice of Change (ANOC) -- the letter your plan sends you in September. Better yet, call me. I review my clients' plans every year at no charge and alert them when a better option is available.
Mistake #4: Waiting Too Long to Get a Medigap Plan
Here is something most people do not know: Medigap plans can turn you down based on health history -- except during your Medigap Open Enrollment Period.
Your Medigap Open Enrollment Period is a 6-month window that starts the month you are both 65 and enrolled in Part B. During this window, insurance companies cannot deny you coverage or charge you more based on pre-existing conditions.
After that window closes, you can be denied or charged significantly higher premiums based on your health.
The fix: Enroll in a Medigap plan during your 6-month open enrollment window. Do not wait until you get sick to think about it -- by then, it may be too late to get the plan you want at a standard rate.
Mistake #5: Assuming Medicare Covers Everything
Medicare does not cover everything. Some of the most common gaps that surprise seniors:
- Dental care -- routine cleanings, fillings, dentures (not covered by Original Medicare)
- Vision -- routine eye exams and glasses (not covered)
- Hearing aids -- not covered by Original Medicare
- Long-term care -- nursing home care beyond 100 days
- Overseas care -- limited coverage outside the U.S.
The fix: Understand what Medicare does and does not cover before you need it. If dental, vision, and hearing are important to you, a Medicare Advantage plan that includes these benefits may be worth considering. For long-term care, a separate long-term care insurance policy is worth exploring.
The Bottom Line
Medicare is complicated, and the stakes are high. The good news is that every one of these mistakes is avoidable with the right guidance.
That is exactly what I am here for. Call me at (386) 871-3858 -- I will make sure you get into the right plan at the right time, and I will be there every year to make sure it stays that way.
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About the Author
William Gray
Independent Medicare BrokerUS Air Force Veteran · Florida Medicare Specialist
William Gray is an independent Medicare insurance broker based in Daytona Beach and Palm Coast, FL. A US Air Force veteran (A-10 crew chief, Germany), he spent years in corporate insurance before going independent to serve Florida seniors directly. He has helped more than 1,000 clients across Northeast Florida compare Medicare Advantage, Medigap, and Part D plans — always at no cost to the client.
