Common Medicare Mistakes and How to Avoid Them

After you turn 65, Medicare will be one of the most significant benefits you utilize, but it is also one of your most confusing. After over a decade of assisting thousands of seniors navigate Medicare, I’ve seen the same expensive mistakes happen again and again.

What is the problem? A lot of individuals do not know they are making these mistakes until it is too late. Some of them may cost you hundreds of dollars a month for the rest of your life.

This detailed guidance will show you the five largest errors people make with Medicare, explain why they are so bad, and offer you easy measures to prevent them. Let us get started!

Mistake #1: Automatically Keeping Employer Insurance Without Comparing to Medicare

The Situation

A lot of people who are getting close to 65 say, “I do not need Medicare because I have good insurance through my job or retirement.” It makes sense, but this is often wrong.

Why This Hurts You:

1. You’ve Already Paid for Medicare

• Your payroll taxes funded Medicare your entire career.
• Not using it means leaving benefits you’ve already earned.

1. Employer Plans Often Cost More

• Typical employer deductibles: $1,000+ per year
• Medicare Supplement deductibles: Just $257/year
• Many Medicare Advantage plans: $0 deductible

1. Coinsurance vs. Copays

• Employer plans usually charge 20% of medical bills after deductible.
• Medicare Advantage plans use fixed copays (e.g., $20 doctor visits).

Example: A $50,000 hospital stay

• Employer plan: You’d pay $9,800 (after the $1,000 deductible)
• Medicare Advantage: Might just pay a $300 copay

The Smart Solution:

During your Initial Enrollment Period, which lasts from three months before you turn 65 until three months after, get a professional comparison. Remember that you can drop your job coverage to switch to Medicare.

Mistake #2: Not Reviewing Your Medicare Plan Annually

The Problem

Medicare plans change every year, but 60% of people never check if their plan still fits their needs.

What Can Go Wrong

• Your drug plan may no longer pay for the medicines you take.
• Your doctor or hospital might drop out of your Advantage plan’s network.
• Plans that are better or cheaper might come up.

Real Consequences

One client didn’t review his plan and didn’t realize:

• His blood pressure medication was no longer covered.
• He wound up paying $487/month instead of his usual $15 copay.
• This went on for 8 months before he noticed.

How to Prevent This

The Annual Enrollment Period starts from October 15 to December 7. Set up a free 10-minute checkup with your Medicare agent during this time. Question to ask:

• Are my drugs still covered?
• Are my doctors still in-network?
• Are there plans with lower premiums/copays?

Mistake #3: Missing Part Deadlines (And Getting Lifelong Penalties)

The Scary Truth

If you do not sign up for Part B (health insurance) and Part D (drug coverage) when you are first qualified and do not have other coverage that meets the requirements, you will have to pay fines for life.

How Penalties Work

Part B Penalty

• 10% more in premiums for every year you wait
• For example: Why wait for two years to sign up? Always pay 20% more each month.
• Part B premiums are $185 in 2025; a penalty would raise that to $222.

Part D Penalty

• 1% of “national base premium” ($36.78 in 2025) per month uninsured
• Example: 24 months without coverage → 24% of $36.78 = $8.83 extra monthly

When You CAN Delay

Only if you have:

Active employment health insurance (from you or your spouse) and “Creditable coverage” (as good as Medicare)

How to Avoid Penalties

Sign up during your Initial Enrollment Period, which lasts from three months before your 65th birthday to three months after. You also have a Special Enrollment Period of eight months if you are leaving your employer’s coverage.

Mistake #4: Assuming Medicare Covers Dental/Vision/Hearing

The Hard Reality

Original Medicare (Parts A & B) covers

• Hospital stays
• Doctor visits
• Medical procedures

But does NOT cover

• Dental: Cleanings, fillings, dentures, extractions
• Vision: Glasses, contacts, routine eye exams
• Hearing: Exams, hearing aids

Why This Matters

The average retiree spends $1,100+/year on uncovered dental/vision costs.

Your Coverage Options

Medicare Advantage (Part C) Plans

• 95% include dental/vision benefits

Example coverages:

• $1,000 annual dental allowance
• Free annual eye exam + glasses allowance

Standalone Dental/Vision Plans

• Available if you keep Original Medicare
• Typically cost $20-$50/month

Mistake #5: Trying to Navigate Medicare Alone

The Complexity Problem

In an average county, you’ll choose from:

• 50-100 Medicare Advantage plans
• 15-20 Part D drug plans
• 10 Medigap plans (if going Original Medicare route)

Hidden Dangers

• Some plans only appear if you qualify for special needs programs.
• Formularies (covered drugs) change annually.
• Networks (covered doctors) change annually.

Why Professional Help is Better

Medicare agents/brokers such as (LMS Insurance Group):

• Are paid by insurance companies (no cost to you)
• Know about plans that don’t appear on Medicare.gov
• Can spot potential problems before they happen

How to Get Good Help

Find a broker that works with more than one company, like LMS Insurance Group. Stay away from agents who only sell one type of plan. Ask, “What other options did you think about for someone like me?”

Final Checklist

Plan ahead for Medicare to help you save money and stay on track. Now, look at all of your choices side by side. A lot of the time, Medicare’s fees and copays are cheaper than plans offered by employers. Second, check your plan every year during the Open Enrollment Period (October 15–December 7) to make sure it meets your needs. Each year, formulas, networks, and benefits change. Third, sign up for Medicare Parts B and D as soon as you can so you do not have to pay costs for life, unless you have other approved coverage, like a current job plan. Fourth, do not forget how Original Medicare does not cover things like tooth, eye, and hearing care. Think about getting a Medicare Advantage plan or a separate insurance.

A good Medicare broker can help you get through all the red tape for free, keep you away from scams, and save you a lot of money. Follow these steps to save money and get the most out of your money.

Conclusion

Remember that choices about Medicare often have effects that last for a long time. You can get the best service at the best price if you take the time to learn about these important areas.

Need one-on-one help? Get in touch with a qualified Medicare broker (LMS Insurance Group). If you do not make these five mistakes, you will be ahead of 90% of the beneficiaries of Medicare and set yourself up for success in your retirement health care.