Millions of seniors are in the midst of Medicare open enrollment, which runs from October 15 through December 7, but many are finding the procedure difficult. According to a July 2022 research from health care consulting firm Sage Growth Partners, some consumers don't grasp the distinction between Original Medicare and Medicare Advantage, many are overwhelmed by Medicare advertising, and just 4 in 10 people check their plan alternatives each year.

This results in missed Medicare open enrollment opportunities, such as failing to ensure that your physicians are in-network for the following plan year and failing to compare your Medicare Part D prescription drug coverage to other available alternatives.

Here are a few examples of typical Medicare open enrollment mistakes:

1. Failure To Consult Your Physicians In 2023

If you have a Medicare Advantage plan, you must typically seek medical treatment from providers in the plan's network, which might change at any moment. Make sure your favorite medical providers are still in the plan's network in 2023 before deciding to stay with it.

Because websites and provider directories aren't always up to date, this may necessitate some labour on your behalf.

"I was recently at a client, and [the plan] indicated their doctor wasn't in-network, so we had to call the provider and seek up a different site on the network side," Evan Tunis, president of Florida Healthcare Insurance, says. "I would recommend calling the doctor's office and simply confirming with them."

2. Failure To Compare Prescription Medication Plans

Your prescription medication coverage is provided by a commercial insurance carrier, regardless of whether you have Original Medicare or Medicare Advantage, and it may vary each year. In 2023, your usual prescription drug may cost more, or your insurer may refuse to cover it at all. (A different plan may cover it for less.)

It is worthwhile to enter your medications into Medicare.gov to see what plans are recommended for you. Pro tip: If you log in to your Medicare.gov account, your prescription history is already there.

"It makes it much easier for people to buy for the next year," says Katy Votava, who holds a Ph.D. in health economics and nursing and is the president and founder of Goodcare, a Medicare consulting organization. "They don't have to do everything line by line and milligram by the milligram."

3. Assuming That Your PPO Plan Will Be Accepted By All Doctors

A preferred provider organization, or PPO, the plan is a type of health insurance that permits members to see out-of-network providers for a fee. People frequently believe that since they have a Medicare Advantage PPO, they may see any doctor they desire. However, providers do not always accept out-of-network coverage.

"If providers don't want to bill the plan, they may just deny someone at the point of service," Tunis argues.

For example, the Mayo Clinic in Florida is out-of-network with most Medicare Advantage plans and will not book visits for people with such coverage.

Choosing Original Medicare plus Medicare Supplement Insurance, or Medigap, "is the most practical approach" for complete provider choice, according to Tunis.

4. Being Persuaded By Flashy Advertisements

Medicare open enrollment season brings a rush of Medicare advertising, and Medicare Advantage plans have enticing features such as no premiums and partial coverage for hearing, dental, and vision care.

However, purchasing health insurance is about more than just the extra perks. "Honestly, most of the time... they don't cover that much dentistry," Votava explains. "Hearing aid coverage is also quite restricted, and this is not a cause to alter your plan, so exercise extreme caution."

More importantly, according to Votava, ensure that the plan covers your physicians and medicines for the following year.

5. Waiting Too Long To Seek Assistance

Medicare open enrollment closes on December 7, but you don't want to wait until the last minute, or even the last week, to begin your investigation. If you have any questions, you can seek assistance from organizations such as the State Health Insurance Assistance Program, or SHIP. Counselors at SHIP programs can provide free guidance with your Medicare options, but they are often overburdened.

SHIP programs are filling up many weeks in advance in various regions of the country. "If you need help, don't put it off," Votava advises.

Shiphelp.org can help you discover your nearest SHIP.