How to Avoid Common Mistakes When Enrolling in a Medicare Advantage Plan
Enrolling in a Medicare Advantage plan is a significant decision that can impact your healthcare and finances for years to come. While these plans offer flexibility, added benefits, and often lower out-of-pocket costs, choosing the wrong plan or misunderstanding the enrollment process can lead to costly mistakes.
Whether you’re new to Medicare or considering switching from Original Medicare to a Medicare Advantage plan in Colorado, understanding how to avoid the most common missteps is essential. With the guidance of an experienced health insurance broker in Colorado like Co Health Brokers, you can make more informed, confident choices about your healthcare coverage.
1. Mistake: Not Understanding How Medicare Advantage Differs From Original Medicare
One of the biggest misconceptions is assuming Medicare Advantage (Part C) works exactly like Original Medicare (Parts A and B). While both offer hospital and medical coverage, Medicare Advantage plans are offered by private insurers and may include extra benefits like:
- Prescription drug coverage
- Dental, vision, and hearing services
- Wellness programs and fitness memberships
However, unlike Original Medicare, most Medicare Advantage plans in Colorado use provider networks (HMO or PPO), which means you may need referrals or be limited to in-network doctors.
Avoid it: Take time to compare the two systems. If you’re unsure which suits your lifestyle and healthcare needs, Co Health Brokers can help you evaluate both options side by side.
2. Mistake: Ignoring Provider Networks
It’s easy to overlook whether your current doctors and specialists are part of a plan’s network. Choosing a plan that doesn’t include your preferred providers can lead to unexpected costs or force you to switch doctors.
Avoid it: Always check that your primary care physician and other healthcare providers are in-network before enrolling in a Medicare Advantage plan. A trusted health insurance broker in Colorado, like Co Health Brokers, can assist with this step to ensure your providers are covered.
3. Mistake: Overlooking Prescription Drug Coverage
Not all Medicare Advantage plans include prescription drug (Part D) coverage. If you need medications, skipping this detail could leave you paying out-of-pocket or having to enroll in a separate plan, which can be tricky.
Avoid it: Review the formulary (the list of covered drugs) for each plan you’re considering. Make sure your prescriptions are included and affordable under that plan. A knowledgeable broker can help compare drug costs across different plans.
4. Mistake: Missing Enrollment Deadlines
Timing matters. Missing key enrollment periods can mean higher premiums or limited coverage options.
- Initial Enrollment Period: 7-month window around your 65th birthday
- Annual Enrollment Period (AEP): October 15 – December 7
- Medicare Advantage Open Enrollment: January 1 – March 31
Avoid it: Mark your calendar and plan ahead. If you’re unsure when to enroll, consult with Co Health Brokers, a reliable health insurance broker in Colorado, to ensure you don’t miss out.
5. Mistake: Not Comparing All Available Plans
Every county in Colorado may have different Medicare Advantage options. Failing to compare plans can result in missing out on better benefits or lower costs.
Avoid it: Use the Medicare Plan Finder tool or work with Co Health Brokers to compare Medicare Advantage plans in Colorado side-by-side. Look at premiums, deductibles, copays, coverage limits, and added benefits.
6. Mistake: Assuming Cheaper is Always Better
A $0 monthly premium might look appealing, but these plans may come with higher deductibles or limited coverage. What you save monthly could cost you more in the long run.
Avoid it: Balance cost with coverage. Evaluate the total cost of care, including copays, drug prices, and maximum out-of-pocket expenses.
7. Mistake: Enrolling Without Expert Guidance
Medicare is complex, and the wrong plan can result in denied claims or surprise medical bills. Trying to navigate it all alone can be overwhelming.
Avoid it: Partner with a licensed health insurance broker in Colorado, like Co Health Brokers, who specializes in Medicare Advantage plans. Their guidance is typically free to you and ensures you’re choosing a plan that fits your health, lifestyle, and budget.
Frequently Asked Questions
What is the biggest mistake people make when enrolling in a Medicare Advantage plan?
Not fully understanding the plan’s coverage and network limitations. Many people assume all plans are the same or automatically include their doctors and medications.
Can I change my Medicare Advantage plan if I don’t like it?
Yes. You can switch plans during the Annual Enrollment Period (Oct 15 – Dec 7) or during Medicare Advantage Open Enrollment (Jan 1 – Mar 31).
How do I know if a Medicare Advantage plan is right for me?
It depends on your healthcare needs, preferred doctors, and budget. Consulting with a health insurance broker in Colorado like Co Health Brokers helps you make a personalized, informed choice.
Are Medicare Advantage plans available throughout Colorado?
Yes, but availability and plan features vary by county. Comparing options specific to your ZIP code is crucial.
Final Thoughts
Avoiding these common Medicare Advantage mistakes doesn’t have to be difficult. With the right preparation—and the help of a trusted expert like Co Health Brokers—you can confidently choose a Medicare Advantage plan in Colorado that meets your health needs and financial goals.
Whether you’re turning 65, retiring soon, or just reassessing your coverage, remember: it’s not just about picking a plan. It’s about picking the right plan. Co Health Brokers is here to guide you every step of the way. Need help choosing the right Medicare Advantage plan in Colorado?
Contact Co Health Brokers today for free, expert assistance. Get peace of mind knowing your healthcare is in good hands.
- Published in Colorado, health insurance
DECEMBER 1: TIME TO GET THAT HEALTH INSURANCE YOU’VE BEEN TALKING ABOUT
Since last year, Thanksgiving has a new meaning for people who need health insurance. The time for buying individual and family plans (as opposed to plans through your work) is approaching. If you need to be sure your 2014 insurance is still the best option, or if you are looking for insurance the very first time, the application deadline is very close. Your quickest path to insurance? Call one of our certified brokers to get individualized hands on help at no charge.
DEADLINE: December 15 is the deadline to apply for individual health insurance that begins January 1. Since there are no medical qualifying hoops to jump through any more, you need only apply to get health insurance for yourself and your family. Applications must in no later than Dec. 15 if you want your insurance to begin on January 1.
HOW TO CREATE AN ACCOUNT ON THE COLORADO EXCHANGE: If you want to buy insurance for 2015, it is helpful to have an account on the Connect for Health Colorado (Connect) Marketplace (the state’s health benefit exchange. Click on this link for a guide to doing this: https://www.dropbox.com/s/q3iy9dw8b5df9dl/CreateAccount112814.pdf?dl=0
HOW TO APPLY FOR FINANCIAL ASSISTANCE: Financial assistance with health insurance premiums depends on income level and family size. You may qualify for financial assistance for 2015 if your family income is less than these amounts:
Individual: $46,680
Two People: $62,920
Four People: $95,400
For self-employed people, income is after your business expenses. To create an account on Connect for Health Colorado and see how much assistance you qualify for, click on this link for our easy-to-follow, free guide to doing this: https://www.dropbox.com/s/3bi0fajhm03gnoe/NewCustomerWithFinancial%20Assistance%20app113014.pdf?dl=0
If you want to purchase a plan, but do not qualify or want to apply for financial assistance, use this link for instructions on how to shop for a plan on the Colorado Marketplace: https://www.dropbox.com/s/1t6k83zqlwbheod/NewCustomerNoFA113014.pdf?dl=0
IF YOU HAVE QUESTIONS OR PROBLEMS: If you have technical or computer problems creating an account or completing the financial assistance application, you can call Connect’s Customer Service line at 855-752-6749 for help solving the problem. For questions or issues related to your insurance, rely on your broker.
FINDING THE BEST PLAN: There is no single best health insurance plan. The best plan for each person balances the monthly cost of the insurance, with the health of the person, their preferences for certain doctors, and likely out of pocket costs. My role as a broker is to help compare all available plans to find the one that best meets your needs and requirements. You do not pay anything extra to use a broker.
At Colorado Health Brokers, we all live in Colorado and enjoy helping people find the best possible health insurance plan for their particular situation. I am a broker, also trained and certified toq help find financial assistance to help with insurance premiums. There is no charge to you for the help I provide.
Hal Winslow
Colorado Health Brokers
720-323-9747 cell/303-541-9533 ofc