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Three Medicare open enrollment mistakes to avoid at all costs

Your annual opportunity to improve coverage could be an occasion for enrollment blunders. Here are three big pitfalls to avoid.

Maurie Backman | August 18, 2022

Key takeaways

Medicare’s open enrollment period is – for millions of beneficiaries – a welcome opportunity to make changes to Medicare health plans – changes that could result in lower costs and dramatically improved coverage.

But if you’re among those who can’t wait to make some changes, you should know that open enrollment can also be an occasion for major enrollment blunders. Here are three that you’ll want to steer clear of.

1. Choosing an Advantage plan where your providers aren’t in-network

Medicare Advantage offers several benefits you won’t find in Original Medicare, including expanded coverage for dental, vision, and hearing services (much of the time), and – in some cases – lower premium costs. But if there’s one limitation you should be aware of, it’s that with an Advantage plan, you’re limited to a specific network of providers. Go out of network, and you risk having to pay for your care out of pocket.

The problem? Networks within Advantage plans can change from year to year. If you have a specific provider you’ve come to trust, or whose office is convenient for you to access, then the last thing you want is to stick with your existing Advantage plan only to find that it’s no longer in-network.

Therefore, look out for such changes before sticking to the same Advantage plan off the bat. And if you do find that your preferred providers are no longer in-network, explore your options for switching to a different plan.

Want to make changes to your coverage? Talk with a licensed advisor at 1-844-309-3504.

2. Sticking with the same Part D plan without exploring others

Part D premiums can increase from year to year, making your existing drug plan more expensive. Plan formularies – which determine what you pay for your medications – can also change from year to year, resulting in poor coverage for the drugs you specifically take (keep in mind that most Medicare Advantage plans have integrated Part D drug coverage; the formularies on those plans can change just as they can for stand-alone Part D plans).

Holding on to your Part D plan — either a stand-alone plan or a Medicare Advantage plan that includes Part D coverage — without looking into alternatives is a big mistake that could cost you a fair amount of money, so before you resolve to stick with your current plan, see what choices are available.

But also, reassess your needs. If you’re no longer taking the same prescriptions, you might find a cheaper Part D plan that gives you the coverage you need.

If the idea of combing through different Part D plans seems too overwhelming, try using Medicare’s Plan Finder. It lets you input your location – as well as prescription and pharmacy information – to help you better evaluate your options.

3. Assuming you and your spouse need to be on the same Part D plan

There are certain things it’s nice to do as a couple – but choosing a Part D plan isn’t necessarily one of them.

If you and your spouse take different medications, the plan that’s right for you isn’t necessarily the best choice for him or her. A better bet? Approach the selection process individually, especially since Part D plans generally don’t offer any sort of family discount.

Don’t rush through the process

Open enrollment is nearly two months long, which means you have plenty of time to review your choices and secure the right health coverage for the coming year. Take your time when weighing your plan options; doing so could save you a world of money and stress.

Maurie Backman has been writing professionally for well over a decade, and her coverage area runs the gamut from healthcare to personal finance to career advice. Much of her writing these days revolves around retirement and its various components and challenges, including healthcare, Medicare, Social Security, and money management.

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