Common Medicare Enrollment Mistakes Sherman, Texas Retirees Can Avoid

Most people sign up for Medicare insurance in Sherman exactly once, which is a big part of why it goes wrong so often. There's no practice round. The deadlines aren't intuitive, some penalties follow you for life, and the letters piling up in the mailbox rarely make it clear what you're supposed to do next. Below are five mistakes that come up again and again, plus how to avoid each one.

Missing the Initial Enrollment Period

Your Initial Enrollment Period is a seven-month window wrapped around your 65th birthday. It opens three months before your birthday month, includes that month, and closes three months after. Sign up early in the window and your coverage can usually start the month you turn 65.

Already drawing Social Security? Then you'll usually be enrolled in Parts A and B automatically. Everyone else has to sign up on their own. Plenty of people assume Medicare will reach out to them, and then discover the window already closed. Put a reminder in your phone a year before your 65th. It's the easiest fix on this list.

Delaying Part B Without Qualifying Coverage

Some retirees skip Part B to save the monthly premium. It feels thrifty. It often isn't. Medicare charges a late penalty of 10% for each full 12-month period you could have had Part B and didn't, and in most cases you pay it for as long as you have Part B.

There is a real exception. When you or your spouse are still working and covered by a group health plan from that current job, you can usually wait on Part B without a penalty. Once the job or the coverage ends, whichever comes first, you have eight months to enroll.

Here's where people get caught. COBRA and retiree health plans don't count as coverage from a current job. Say you retire from a Sherman employer at 66 and stay on COBRA for a year and a half. By the time you apply for Part B, your eight months may be long gone. Company size matters, too. At an employer with fewer than 20 workers, Medicare usually pays first, so skipping Part B there could leave you with big bills. 

Skipping Part D Because You Take Few Prescriptions

Taking only a generic or two, a drug plan can look like money down the drain. But Part D has its own late penalty. Go 63 days or more in a row without Part D or other creditable drug coverage after your first window closes, and a penalty may be added to your premium. It grows with every month you went without, and you generally pay it as long as you have Part D.

One new diagnosis can change your prescription list overnight. And a cheap plan you barely use is still cheaper than a penalty you pay for decades.

Letting the Medigap Open Enrollment Window Close

Medicare Supplement plans, or Medigap, help with the costs Original Medicare leaves behind, like deductibles and coinsurance. Your Medigap Open Enrollment Period lasts six months. It starts the first month you're both 65 or older and enrolled in Part B.

Inside that window, insurers can't turn you down or charge you more because of your health. After it closes, Texas insurers can generally underwrite, meaning they can ask about your health history and price the policy accordingly. A heart issue at 67 could make a supplement plan harder to get, or a lot pricier.

On the fence between Medigap and Medicare Advantage? Decide during this window. It's the one time every option is fully open to you.

Ignoring the Annual Enrollment Period

Signing up isn't the end of it. Plans can change their premiums, drug lists, and doctor networks every year. The Annual Enrollment Period runs October 15 through December 7, and changes take effect January 1. (Yes, that means right now.)

A lot of Sherman retirees roll their plan over year after year without opening the mail. Then January comes. They're paying more for the same prescriptions, or the doctor they've seen for years at a Grayson County clinic is suddenly out of network. Your plan's Annual Notice of Change shows up each fall, and reading it takes maybe 45 minutes. Skipping it can cost far more than that.

One more thing, for anyone with a Health Savings Account who plans to enroll in Medicare after 65. Stop putting money in at least six months before you sign up. Part A can be backdated up to six months, and contributions during that period may trigger a tax penalty.

Getting Medicare Right the First Time

Medicare is kind to people who plan ahead and hard on people who don't. Know your Initial Enrollment Period. Find out whether your work coverage really lets you delay Part B. Then pick up drug coverage on time, use your Medigap window, and look over your plan every fall.

If you'd rather have someone in your corner, ABear Insurance helps people in Sherman and nearby towns enroll in Medicare and compare plans from many companies. Jennie Hebert started the agency after going through Medicare with her own mother, and the team still helps clients with the maddening parts, like pharmacy questions and endless phone menus. There's no cost to clients. With fall enrollment open, this is a good week to make sure your plan still fits.

ABear Insurance is an independent insurance agency based in North Texas that helps individuals and families find Medicare, life, and health insurance coverage. Founded by Jennie Hebert after she helped her own mother through the Medicare process, the agency focuses on education and compares plans from multiple carriers at no cost to clients. Learn more at ABear Insurance.