Choosing a Medicare plan is one of the most important decisions you’ll make when it comes to protecting your health and finances. With so many options, rules, and potential costs, it’s easy to feel overwhelmed. But the truth is, selecting the wrong plan—or overlooking certain details—can lead to higher out-of-pocket expenses, limited access to doctors, or gaps in the care you need.

Making an informed choice about your Medicare coverage requires a careful understanding of common mistakes and how to avoid them. By learning from the challenges others have faced, you can confidently choose a plan that supports your health and lifestyle. According to Forbes, as of April 2024, approximately 67.3 million U.S. adults are enrolled in Medicare coverage, which makes choosing wisely more important than ever.

Below, we’ll cover the top mistakes people make when selecting Medicare plans and how you can sidestep them to ensure your needs are met.

Not Comparing All of Your Options

One of the biggest mistakes people make is assuming that all Medicare plans are the same or that their first choice is automatically the best one. Medicare offers multiple options, including Original Medicare (Parts A and B), Medicare Advantage (Part C), and standalone prescription drug coverage (Part D). In addition, supplemental Medigap policies can help cover costs that Original Medicare does not.

Each of these plans comes with its own set of rules, costs, and benefits. Failing to compare them side by side could mean missing out on better coverage or lower premiums. For example, Medicare Advantage plans often include additional benefits like vision and dental, but they may also have limited provider networks. On the other hand, Original Medicare offers flexibility in choosing doctors but doesn’t cap out-of-pocket costs.

Taking the time to evaluate all your options ensures you’re not stuck with a plan that doesn’t suit your lifestyle or financial situation.

Ignoring Prescription Drug Coverage

Prescription drug costs can add up quickly, and many people make the mistake of assuming they won’t need Part D coverage if they don’t currently take medication. Unfortunately, this can lead to costly penalties and coverage gaps later on. If you decide not to enroll in Part D when you’re first eligible and then need it later, you’ll face a permanent late enrollment penalty that increases the longer you wait.

Even if you’re in good health now, it’s wise to plan for the future. Medications are often a necessary part of aging, and having drug coverage in place can protect you from high expenses down the road. Reviewing different Part D plans and ensuring your medications are covered can prevent frustrating surprises and ensure your healthcare budget stays manageable.

Overlooking Provider Networks

Another common mistake is forgetting to check whether your preferred doctors and specialists are included in a plan’s network. This is especially true for those considering Medicare Advantage plans, which typically operate within a set group of providers. If you enroll in a plan without confirming that your physicians participate, you may end up paying significantly more out-of-pocket or needing to switch doctors altogether.

Always double-check provider directories before enrolling. It’s also a good idea to confirm directly with your doctor’s office, as networks can change from year to year. By making sure your providers are included, you’ll maintain continuity of care and avoid unexpected bills.

Misunderstanding Out-of-Pocket Costs

Premiums are only one piece of the puzzle when it comes to Medicare coverage. Many people focus solely on the monthly premium price and fail to account for other costs like deductibles, copayments, and coinsurance. These expenses can add up quickly, especially if you have ongoing medical needs or require hospital stays.

For instance, a plan with a low premium might seem attractive but could come with high out-of-pocket expenses when you actually need care. On the other hand, a higher premium plan may offer better cost-sharing protections and lower annual expenses overall. The key is to look at the total cost of coverage, not just the monthly price tag.

Failing to Consider Future Needs

It’s natural to base decisions on your current health, but overlooking potential future needs is a mistake. Healthcare demands typically increase with age, and the plan you choose today should be flexible enough to handle changes down the road.

Think about whether you may need specialized care, access to certain medications, or even long-term treatments in the future. Choosing a plan that offers comprehensive coverage now can save you from needing to switch later or facing limited benefits when your needs grow. Planning ensures your Medicare coverage remains reliable no matter what comes your way.

Skipping Annual Reviews

Many people assume that once they pick a Medicare plan, they’re set for life. In reality, plans can change from year to year. Premiums, provider networks, drug formularies, and benefits often shift, meaning a plan that worked well last year might not be the best fit now.

The Annual Enrollment Period (AEP), which runs from October 15th to December 7th each year, gives you the chance to review your plan and make changes if necessary. Failing to take advantage of this opportunity could leave you stuck with higher costs or reduced benefits. By reviewing your plan annually, you can adapt to changes and ensure your coverage remains the best choice.

Overestimating What Original Medicare Covers

Another mistake is assuming that Original Medicare covers everything. While it provides hospital and medical insurance, it doesn’t cover all services. For example, dental care, vision exams, hearing aids, and most long-term care services are not included. This can come as a surprise to many enrollees, especially those who didn’t plan for additional expenses.

To avoid unexpected costs, consider whether a Medicare Advantage plan or a supplemental Medigap policy would better suit your needs. These options can help fill the gaps left by Original Medicare and give you more comprehensive coverage.

Forgetting About Travel Coverage

If you plan to travel frequently, especially outside of the United States, forgetting to check your Medicare plan’s travel coverage can be a costly mistake. Original Medicare generally does not cover healthcare outside the country, and many Advantage plans have limited networks that may not extend beyond your local area.

If travel is part of your lifestyle, look for supplemental policies that include foreign travel emergency benefits or consider plans that provide broader access to care. Ensuring you’re protected while traveling can save you significant stress and expense in the event of a medical emergency away from home.

Selecting a Medicare plan doesn’t have to be overwhelming, but avoiding the most common mistakes is key to getting the right coverage. By comparing options, reviewing provider networks, considering drug coverage, and planning for both current and future needs, you’ll set yourself up for success. Remember to review your plan each year and make adjustments as your health and lifestyle change.

Medicare is a critical part of protecting your health and financial stability. With so many people relying on it, taking the time to choose wisely ensures you’ll enjoy peace of mind and reliable access to care for years to come.

If you’re ready to explore your options and avoid costly mistakes, Teton Medicare is here to help. Our knowledgeable team can walk you through the process, answer your questions, and match you with the plan that fits your unique needs. Contact us today to get started and secure the Medicare coverage you deserve.