MEDICARE'S MOST COMMON ENROLLMENT MISTAKES

Michael T. Braden, August 23, 2025 MEDICARE ENROLLMENT

Braden Medicare Common Mistakes You Won't Want To Make During Medicare Enrollment

After reading this article, you will know more about Medicare, Medicare Enrollment Periods, and how to avoid common mistakes.

Medicare is pretty simple once you get used to it, but it can certainly be confusing when you first start researching it, and especially when you first enroll in Medicare. We have seen the best-intentioned people make mistakes that could have been easily avoided if they had only asked for help. Therefore, we are dedicating this article to everyone who wishes they had a mulligan when they first enrolled in Medicare.

1. DELAYING YOUR MEDICARE START DATE BASED ON YOUR ENROLLMENT DATE

   
   

   Medicare has several separate Enrollment Periods each year (AEP, IEP, OEP, SEP), which can be confusing for anyone. But your Initial Enrollment Period (IEP) is by far the most important one of them all.

   
   

   There can be consequences and penalties if a new Medicare Beneficiary does not enroll in Medicare within their IEP, provided they have no other "Creditable Medical Coverage", such as a Group Employer Health Plan from a company with more than 20 Employees, or FEHB Members.

   
   

   Everyone has the same Initial Enrollment Period for Medicare. The Seven-Month Period starts three months before your birth month and ends three months after it.

   
   

   Many people with employer-sponsored Group Health Insurance who plan to work past Age 65 can delay their IEP until they retire and their Group Health Insurance ends. For these people, their IEP will begin once their Group Health Insurance ends.

   
   

2. COBRA IS NOT CONSIDERED CREDITABLE COVERAGE BY MEDICARE

   
   

Many people dislike the cost of having COBRA coverage as a short-term solution for Maintaining Health Insurance from the time they retire from their employer until

Medicare coverage begins. The price is outrageous, but perhaps the worst thing is

that it gives people a false sense of security. This is because, although it is considered health coverage, no COBRA plan is approved by Medicare (CMS) to be health insurance that is at least equal to Medicare.

Because COBRA plans are not standardized, they can vary significantly from one person to another when enrolling in a qualified Medicare or company. You must remember to enroll in a qualified Medicare Plan during your Initial Enrollment Period (IEP). If you do not enroll in a qualifying Medicare Plan, Original Medicare, or a Medicare Advantage Plan (Medicare Part C), you could be subject to paying a Medicare Penalty for life.

3. NOT UNDERSTANDING WHAT IT MEANS IF YOU WORK FOR A SMALL EMPLOYER

Did you know that Medicare categorizes Group Health Insurance (Employer Group Health Benefits) into two categories, based on the number of employees it covers? Medicare indeed defines "small" employers as those with fewer than 20 employees, and they refer to employers with more than 20 employees as "large" employers.

Why does the size of the company matter? Well, Medicare does not classify Small Employer Group Health Coverage as being creditable, and, as such, you must enroll in Medicare as soon as you turn 65. Small Employers are not permitted to offer health insurance to anyone after age 65. This means that you need to be enrolled in Medicare before you are three months past your birth month! If you do not enroll in Medicare during your Annual Enrollment Period, Medicare will impose a Part B Late Enrollment Penaltyand, in some cases, a Part D Late Enrollment Penalty, which never goes away.

Because COBRA plans are not standardized, they can vary significantly from person to person and company to company. It is essential to remember that you must enroll in a qualified Medicare Plan during your Initial Enrollment Period (IEP). If you do not enroll in a qualifying Medicare Plan, Original Medicare, or a Medicare Advantage Plan (Medicare Part C), you could be subject to paying a Medicare Penalty for life.

4. BILLING ISSUES AND YOUR PART B DEDUCTIBLE

Perhaps the biggest problem most people face in their first year of Medicare enrollment is billing errors. This is because your Doctor will bill Medicare or your Medicare Advantage Plan directly after you pay any coinsurance or copay amounts for the services you receive. Unfortunately, for those with a Medigap or Medicare Supplement plan, doctors' offices often bill your insurance in addition to Medicare. This can create an unnecessary mess.

Many people who have chosen Original Medicare forget that they must meet the Medicare Part B deductible before Medicare will pay for any services. Depending on where you live, the deductible may be paid at the doctor's office, or you may receive an invoice from Medicare.

It is essential to note that the doctor/provider bills Medicare (if you have Original or Traditional Medicare), and Medicare will then send any remaining balance to your supplemental carrier for payment. It is not permitted for a provider or doctor to text, email, call, or harass a Medicare beneficiary to obtain payment. If they have questions, they should contact Medicare (CMS) directly.

Here at Braden Medicare Insurance, we have developed a "Patient Information Cover Sheet" that we give to each of our clients. We have found that it has dramatically reduced billing errors and is a valuable tool. If you are interested in this or would like to learn more about how it works, please don't hesitate to contact us.

5. THINGS TO REMEMBER DURING THE MEDICARE ANNUAL ENROLLMENT PERIOD (AEP)

The Medicare Annual Enrollment Period takes place every Fall, from October 15th through December 7th.

The Medicare Annual Enrollment Period (AEP) Runs From October 15th through December 7th each year.

During the AEP, you can pick a new Medicare Advantage or a new Medicare Part D Prescription Drug plan for the new year beginning on January 1st. You can switch from Original Medicare to a Medicare Advantage plan, and your changes will take effect on January 1st. You can leave your Medicare Advantage plan and re-enroll in Original Medicare, effective January 1st.

If you are satisfied with your Stand-Alone Medicare Part D PDP plan and it is available for next year, you do not need to take any action; your plan will automatically renew.

Lastly, if you have chosen Original/Traditional Medicare with a Medicare Supplement/Medigap plan, you do not need to do anything during the Medicare AEP (Annual Enrollment Period). This is because once you purchase a Medigap policy, it is considered to be permanent. You can always apply for a new Medicare Supplement/Medigap plan with the same or a different carrier, any day of the year.

WRAPPING THINGS UP

Medicare has numerous rules, regulations, and protocols. However, once you are aware of them, things should proceed smoothly, and most people are generally satisfied with Medicare. If you have any questions, please don't hesitate to contact your broker. If you do not have a Medicare Broker, feel free to call us anytime; we are always happy to answer your questions.

Braden MEdicare Insurance Business Card For Michael Braden