# October, 24, 2019

7 Costly Medicare Mistakes and How to Avoid Them

Most of us make minor mistakes every day and few of them life altering. Some mistakes, though, may cost you – literally. In this post, we share seven costly Medicare mistakes and explain how to avoid them.

1. Paying Your Deductible Before Medicare Processes the Claim

Both Medicare Part A and Part B have deductibles. Part B’s is annual while Part A is a bit more…complicated (see the link in that first sentence). In both cases, though, the Medicare process states that the medical provider bills Medicare first and then the patient pays the deductible.

The reason for this is simple. The first provider to bill Medicare is the one that has the deductible taken from their payment. That provider will then bill you for the deductible. And it won’t matter if you already paid the deductible to another provider. You still have to pay it to whoever billed Medicare first. The first provider should reimburse, but that can be an uphill battle.

This happens most often with Medicare Part B, especially when it’s your annual wellness visit. You finish your checkup and the doctor sends you to the lab for bloodwork. Before heading over to the lab, you stop at the front desk to pay your co-insurance. Then, when the clerk asks you for the deductible, you go ahead and pay that, too. Unfortunately for you, the lab sends its bill to Medicare first. And that’s where you get hit with the double deductible.

The solution here is simple. When the front office person asks you to pay the deductible, remind them that procedure says they have to bill Medicare first.

2. Ignore the Annual Notice of Change

We’ve talked about this before, but it is really important you don’t ignore the Annual Notice of Change (ANOC). As a reminder, the ANOC is sent to anyone who has a Part D or Medicare Advantage (MA) plan. And it lists every change expected by your plan next year.

Common changes listed in the ANOC include:

  • Providers leaving your plan’s network
  • Drugs leaving your plan’s formulary
  • Premiums, co-pay, and other out-of-pocket costs changing

You get the ANOC a month before Annual Enrollment begins specifically so you can review it and make any necessary changes for next year’s coverage. Failure to read it is not an excuse if you suddenly find your doctor no longer accepts your MA plan. Or that your Part D plan no longer covers one of your medications.

This mistake is also easy to avoid, since all you have to do is read the ANOC and then act accordingly.

3. Not Paying Your Part B Premium

Once you begin receiving Social Security benefits, your Medicare premium is deducted without you having to do anything. But, if you’re one of the millions of Americans who enroll in Medicare before signing up for Social Security, you’re billed quarterly. Missing a payment means you may lose your Part B coverage. You’ll also lose your Medicare Supplement Insurance plan and MA plan, if you have those.

If this happens, the only coverage you’ll have left is your Part A hospital insurance. Unless, of course, you don’t qualify for premium-free Part A. In that case, you lose Part A coverage as well.

You can’t enroll again until the Open Enrollment Period that runs from January through March. And you’ll have to wait until July 1 for coverage to begin. Depending on how long you’ve been without coverage, you may even wind up with late penalties. And, of course, you’re responsible for any medical bills you have during this time.

This page from My Medicare Matters walks you through setting up automatic payment for your Medicare premiums.

4. Forget to Notify Medicare when Your Employer Coverage Ends

Many people who qualify for Medicare already have coverage through an employer. Maybe they’re still working when they turn 65. Or, their spouse may still be employed and they enjoy healthcare coverage that way.

In either case, if your employer-sponsored insurance ends, someone must notify Medicare. Typically, the employer’s benefits administrator completes this step. But mistakes happen (see paragraph 1 of this article). And this is one of those mistakes that can cost you.

Until someone says differently, Medicare thinks it’s your secondary insurance. That means it will deny any claims received that didn’t first go through your old carrier. Even if you’re confident the employer will notify Medicare, we always recommend calling them yourself. It’s simple. Just call 1-800-MEDICARE and tell the person who answers that you need to make sure they know your former coverage ended (or is about to end).

Denied Medical Claim

5. Fail to Get Preventive Screenings Via Your Primary Care Physician

Your Medicare Part B benefits cover numerous preventive screenings, starting with your Welcome to Medicare visit. However, Medicare only covers preventive care when it’s provided by your primary physician.

In addition, secondary services received at the same time may not be covered. The most common surprise charge here is for the anesthesiologist who sedates you before a colonoscopy. If you aren’t sure whether a service is covered, ask your provider.

6. Use the Wrong Medicare Card

In addition to your Medicare card, you may also have cards for your Part D, MA, or Medigap plan. Presenting the wrong one could result in denied claims, which leaves you paying 100 percent of the bill.

You’d think this wouldn’t present a problem – surely the person accepting payment would notice you used the wrong Medicare card. Unfortunately, it does happen. Really, the only solution here is to be careful. Remember that Part D only covers prescriptions you receive at the pharmacy. If you have an MA plan, store your red, white, and blue Medicare card someplace safe.

7. Fail to Use a Licensed Medicare Agent

Navigating your way through the Medicare program can be confusing to say the least. You have so many options, and what was best for your friend may not be what’s best for you. The licensed agents at MedicareUSA help you understand your Medicare options and which plans work best for your unique needs. For some, it’s Original Medicare plus a Part D plan and Medigap. Others would do best with a Medicare Advantage plan. Medicare brokers work with you to determine the best choice for you. The best part? It’s free.

Conclusion

Now that you know what they are, most of these mistakes are fairly easy to avoid. If you’re ready to begin reviewing plan options in your area, our plan finder tool makes it easy. Just enter your location and when you want to begin coverage.

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Kolt Legette

Since 2015, Kolt Legette has helped clients navigate the often-confusing world of insurance. His number one goal is protecting the medical and financial wellbeing of every person he speaks with, whether they choose to buy insurance or not. Kolt loves representing the best brands in medical insurance as it allows him to provide side-by-side comparisons for his clients. This allows the client to decide which company works best for them. By putting the needs of the client above everything else, Kolt helps real people find affordable health insurance solutions for their most pressing healthcare needs. With his belief that peace of mind is priceless, Kolt's goal in every interaction is to make sure every person he speaks to leaves with the peace of mind they rightfully deserve.

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Last Updated 12/21/2018