Avoiding Costly Mistakes in Medicare, Understanding Medicaid Changes

Every year seems to bring about changes to Insurance Eligibility, coverage and costs. This next year is no different except the changes are possibly more extreme and will affect many more people. Let’s review how to mitigate costly mistakes and understand some changes you need to be aware of.

Here are 11 mistakes that can cost you dearly when signing up for or changing Medicare Plans.

1. Buying the same Medicare Part D plan as your spouse: Your health and needs are not the same, so you should choose a plan for individual needs.
2. Not reviewing your Medicare Part D plan yearly. Medicare changes drugs on formulary, providers as well as co-pay deductible and max out of pocket cost yearly
3. Going out-of-network in your Medicare Advantage Plan: Make sure you are using in-network providers to get the lowest cost for your care.
4. Not switching Medicare Plans mid-year if needed. Review your care requirements and make sure you have the proper coverage.
5. Not picking the right Medigap Plan at the right time: Be aware of the enrolling criteria for  a Medigap plan so that you do not miss out on guaranteed-issue or options to change Medigap plans during the year. Be aware of state specific requirements. 
6. Forgetting you can sign up for Medicare at age 65: Be aware of your eligibility dates and prevent lifetime surcharges coverage delays for Medicare Part B due to delaying your Medicare signup. If you work, review the options you have available to you and understand the risks and or rewards for delaying Medicare enrollment.
7. Not signing up for Medicare Part B if you have retiree or COBRA coverage.
8. Forgetting about the Medicare Part B enrollment deadline after leaving your job: Not enrolling within a specified period of time will cause a lifetime surcharge to be added to your premium.
9. Making financial moves that can increase your Medicare Premiums: Selling out of financial positions, increasing reportable income can change your Medicare part B premium. 
10. Not contesting the high income surcharge for the year you retire or subsequent years. If your income has dropped after a surcharge was added due to high income initially, you can submit proof of reduced income and request that your premium be reduced accordingly.
11.  Signing up for Medicare Part A if you want to contribute to an HSA.  you cannot contribute to a HSA after you have signed up for Medicare, but that doesn’t necessarily mean that you have to stop making contributions at the age of 65. If you or your spouse has health insurance through your current job, you can delay signing up for Part A and Part B and keep contributing to an HSA. Though not an option if you have already signed up for SocialSecurity or your employer has fewer than 20 employees.

How to navigate Medicare Sales tactics

Review your plan often.

Beware of beneficiary changes to the policy and or policy being changed to a different carrier.Make sure the plan you are in is affordable and meets your needs as best as possible. Be aware that the costs as well as the provider coverage of your plan can change yearly. If an agent says otherwise, don’t believe them.

We are coming upon Medicare open enrollment periods. Please make sure to review all of your options and especially your current plans as deductibles, co-pays, networks, Max out of pockets may have changed.

Here are some other things you need to be aware of

• Home visits, phone solicitations or unsolicited emails. (Not allowed)
• Note: Medicare is not free!
• Request for you to switch your plan. Only if it is in your best interest and you have made comparisons for your needs.
• Remember Medicare Advantage Plans do affect your Medicare coverage.
• Do your homework. Medicare Advantage Plans are not always the best plans!
• Remember you can only switch plans during designated enrollment periods.
• Beware of hidden permissions to contact you.
• Be aware of high pressure sales tactics.

Medicaid changes that may affect you that are already begging to be put in place by some states. There will be work requirements for those able to work and under age 65. You will be required to work and continue to prove working 80 hours a month or volunteering for the same amount of time or care giving for 80 hours a month. Other requirements may be made depending on your state of issue. States are going to be required to foot most of the cost of Medicaid. The problem lies when the state cannot afford to do so. This is even more of a challenge for states that do not have the income tax base, such as TN, FL, NV and others. 

Additional challenges that patients may face if no longer eligible for Medicaid; not being able to get insurance anywhere. Their income may be too high to qualify for Medicaid and their income is too low to afford the ACA. The subsidies for ACA, The Affordable Care Act are set to expire at the end of the year. The estimated increase for many enrollees will be between 85% and 200%. 

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