THE TOP 10 MEDICARE MISTAKES TO AVOID

Michael T. Braden December 11, 2025 MEDICARE ENROLLMENT

Enrolling in Medicare is a pivotal step, heralding a secure and healthy retirement. However, navigating the path to the right coverage can be challenging, with intricate rules, complex choices, and costly pitfalls.

Braden Medicare Insurance's Top Ten Medicare Mistakes Poster

UNDERSTANDING AND AVOIDING THE TOP 10 MEDICARE MISTAKES FOR NEW ENROLLEES

Selecting your Medicare coverage is a crucial financial and health decision. By recognizing common errors, you can confidently navigate the process and choose a plan that safeguards both your health and finances.

WHY MANY NEW MEDICARE BENEFICIARIES MAKE INCORRECT INITIAL DECISIONS

If Medicare feels overwhelming, you're not alone. The system combines government-run programs (Parts A and B) with private insurance options (Part D, Medicare Advantage, and Medigap). With various enrollment windows, cost structures, and rules, it's easy to make a costly mistake that could limit your access to care when you need it most.

#1 MISSING CRUCIAL ENROLLMENT DEADLINES

This is perhaps the most critical error. Your Initial Enrollment Period (IEP) is your prime opportunity to enroll. Missing it without qualifying for a Special Enrollment Period (such as having employer coverage) may result in lifelong late enrollment penalties.

The Part B penalty, for example, permanently increases your monthly premium. In 2023, nearly 800,000 Medicare beneficiaries paid this penalty, with an average premium increase of 28 percent. Missing your Part D enrollment can also lead to a permanent penalty.

Understanding these dates is crucial. Learn more in our guide, Your Guide to Medicare Enrollment Periods: When to Sign Up.

#2 FOCUSING ONLY ON THE MONTHLY PREMIUM

Choosing a plan with a $0 or very low monthly premium is tempting. Many Medicare Advantage plans offer this feature. However, a low premium often results in higher out-of-pocket costs when utilizing your benefits.

A plan with a higher premium, such as a Medicare Supplement plan, may save you thousands in the long run by covering deductibles and coinsurance. The actual cost of a plan is not its premium but what you'll pay annually, including all medical care.

#3 NOT UNDERSTANDING ORIGINAL MEDICARE COVERAGE LIMITATIONS

Original Medicare (Parts A and B) provides a solid foundation but was never intended to cover 100 percent of medical expenses. It leaves significant “gaps” for which you're responsible.

The most notable gap is the 20 percent coinsurance on Part B services, which has no annual cap. A serious illness or surgery could leave you with thousands of dollars in bills. As detailed in our article What Medicare Doesn’t Cover: Common Surprises, these gaps are precisely why Medicare Supplement (Medigap) plans exist: to fill those gaps and provide predictable costs.

#4 IGNORING ENROLLMENT IN A MEDICARE PART D PRESCRIPTION DRUG PLAN

Even if you currently take a few prescriptions, don't skip enrolling in a Part D drug plan when first eligible. As mentioned, failing to enroll may result in a permanent late-enrollment penalty if you enroll later. Additionally, a sudden health issue could leave you facing the full, high cost of necessary medications without coverage.

#5 NOT COMPARING MEDICARE SUPPLEMENT PLANS TO MEDICARE ADVANTAGE PLANS FAIRLY

These two options function differently. A Medicare Advantage (Part C) plan is an alternative to Original Medicare, while a Medigap (Medicare Supplement) plan complements it.

Each has unique cost structures, rules, and benefits. For a detailed comparison, call us or visit our Blog Archives on comparing Medicare Advantage Plans With A Medicare Supplement plan. Choosing one without understanding the differences often leads to Buyer's Remorse and can cause a chain reaction that too many people never recover from.

#6 NOT VERIFYING IF YOUR PREFERRED DOCTORS & HOSPITALS ARE IN YOUR PLAN'S NETWORK

This mistake mainly applies to Medicare Advantage plans, which typically have restrictive HMO or PPO networks. Your preferred doctor or hospital may not be in the network, or you may need a referral to see a specialist.

This is where Medicare Supplement plans offer superior value. With a Medigap plan, you can see any doctor or visit any hospital in the United States that accepts Medicare.

#7 NEGLECTING TO RE-EVALUATE YOUR COVERAGE ANNUALLY

This is crucial for anyone in a Medicare Advantage or Part D plan. These plans can change their benefits, provider networks, and drug formularies (the list of covered drugs) every year. A strategy that fits perfectly this year might be unsuitable next year.

Medicare Supplement plans, in contrast, are standardized. Their benefits remain consistent year after year, providing a stable, predictable coverage experience.

#8 MISUNDERSTANDING MEDICARE UNDERWRITING RULES FROM THE START

While Medigap plans offer significant flexibility, there is a critical enrollment rule. When first eligible (during your 6-month Medigap Open Enrollment Period), you have “guaranteed-issue rights.” This means an insurance company cannot use your health history to deny you a policy or charge you more.

If you wait to buy a Medigap plan later, you will likely face medical underwriting and may be denied coverage for pre-existing conditions.

#9 COVERAGE WHEN TRAVELING OUTSIDE YOUR COUNTY

If you love to travel or reside in two different states during the year (a “snowbird”), your plan’s network is crucial. Most Medicare Advantage plans have regional networks, limiting coverage to emergency care when out of state.

Medicare Supplement plans travel with you. Since they work with any provider that accepts Medicare nationwide, your coverage is just as adequate in California as in Minnesota.

#10 ATTEMPTING TO NAVIGATE EVERYTHING ALONE

Medicare is complex, but you don't have to master it overnight. Trying to research all options independently can lead to frustration and poor coverage decisions. The best approach is to seek help from a knowledgeable, independent resource.

A licensed, independent Medicare Broker is the way to go; they can explain the pros and cons of each option tailored to your specific situation, budget, and health needs. They can help you avoid common mistakes and develop a plan that provides real peace of mind.

WRAPPING THINGS UP

In reflecting on what I have learned as an Independent Medicare Broker and Certified Medicare Planner, I have found Medicare confusing. No one warns us or trains us on what Medicare is, what Medicare provides, and what things are not covered by Medicare. And, regardless of how smart or successful you are, it is virtually impossible to know everything about Medicare that you need to know on your own.

So what do you do? You can foolishly attend a bunch of seminars, listen to your hairdresser and what her Sister in Illinois told her, or you can reach out to a local, Independent, Licensed Medicare Broker in your area. They will never charge you a dime for their services or expertise. If you are not confident in knowing how to interview a broker, please feel free to call or email me anytime. I would be honored to help you.

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