Top 5 Medicare Mistakes When Turning 65

Top 5 Medicare Mistakes When Turning 65

At 65 you may be looking forward to different things: having grandchildren perhaps, possibly retiring from your career, or taking some trip that you’ve dreamed of your whole life. Sixty-five may also be a significant year for you as it may be the first year that you’re eligible for Medicare. So, make sure that you avoid some of the common Medicare mistakes of people who are turning 65.

Let’s go over the top five big mistakes people make when they’re turning 65. Alright, here they are:

Medicare Part D1. They wait too long to learn about Medicare.

So, the first big mistake people make when they’re turning 65 is they wait too long to learn about Medicare. In the Medicare supplement plans and Medicare Advantage plans, and the Medicare Part D prescription drug plans, if you wait too long, you really could mess yourself up in the future. You want to have this information by three months before the month of your birth or two months is fine. But don’t wait till the month before, if you rush into it you could end up on the plan that’s not right for you and really cost yourself in the future.

2. They don’t take Medicare Part B when they’re first eligible for it.

On to the second big mistake a lot of people make this mistake when they’re turning 65 and it’s very easily avoidable is they don’t take Medicare Part B when they’re first eligible for it. It may save you money now not having to pay the Medicare Part B premiums, but the problem is down the road when you finally need it. They’ll tack on a penalty on top of your monthly premium for the rest of your life. So, it could end up costing you a lot more money than you had thought. The other problem with it is that, if you go without Medicare Part B or any other health insurance and if you end up in the hospital or have any other type of problems then you could have huge medical bills, and you don’t want that.

So, make sure you get Medicare Part B when you’re first eligible for it, unless you have what’s called creditable coverage. Creditable coverage is a coverage that is as good as or better than Medicare. And if you do have that, then you won’t be penalized if you go without Part B, and sign up for that in a later date. If you don’t have credible coverage again, just make sure you get it when you’re first eligible.

Medicare Advantage plan3. They buy the most expensive plan they can find thinking it’s the best thing for them.

So, the third mistake is a silly mistake, but it’s a big one nonetheless. A lot of people do make it; they buy the most expensive plan they can find thinking it’s the best thing for them. If it’s a Medicare supplement plan F that they got for $300 a month, they could get that same thing for $200 a month. If it’s a Medicare Advantage plan that’s $100 a month, they may be able to get the same coverage for zero or $20.00 a month. So, you really want to do your research and make sure that you get the best plan available for your specific needs. Everybody’s a little bit different and you just don’t want to buy the most expensive plan thinking that that’s going to give you the best coverage, because you could just end up spending way too much money for the plan that you have. The agents love it, because they’ll get the most Commission out of it, but it’s not a good thing for you.

4. They get a plan because somebody told them that the plan that they have has done awesome for them and it’s going to be the best thing for them as well.

Mistake number four you get a plan, because somebody told you that the plan that they have has done awesome for them and it’s going to be the best thing for you as well. That’s not always the case! The best plan for you may be different from the best plan from your neighbor your husband wife sister brother or whoever else. So, you want to make sure that you get the best plan for your specific needs whether it’s your health needs or your financial standing. All these things have an effect on what plan is best for you. So, just because someone tells you that their plan is really good and it’s done awesome for them, it may not be the same way for you and it could get you in a lot of trouble in the future. So, be careful and don’t do that.

5. They talk to the wrong agent.

So, the fifth and biggest mistake people make when they turning 65 they talk to the wrong agent. There are two types of agents you really want to steer clear of when you’re turning 65. The first is a lazy agent and the second is a captive agent.

Two types of Medicare Insurance Agents to steer clear of when you’re turning 65:

Independent Medicare Agent1. Lazy Agent

A lazy agent is an agent that will sign you up when you’re turning 65 they’ll get their Commission’s and you’ll never hear from them again. So, when your benefits change or your premiums skyrocket in the future, you won’t be able to get ahold of them, because they’re off servicing the next person turning 65 instead of servicing any of their previous customers. So, you really want to be careful, because they can really mess you up in the future, when you can’t get ahold of them to make any changes and you have to get another agent start all over.

It’s hard to figure out if they are a lazy agent because they’re not going to tell you they’re lazy. So, you’ll want to ask a couple questions just to make sure that they will be available for you in the future, or if they already take care of the current customers.

2. Captive Agent

The second type of agent you really want to steer clear of is a captive agent. A captive agent is an agent that can only represents one company and their plans alone. In the beginning they might have the best plan for you and they might not. If it is the best plan for you in the beginning, that’s great, but in the future, a couple years down the road when the plan changes or the premiums skyrocketed, they’re still going to tell you that plan is the best thing for you no matter what, because that’s what they get paid to do. So, there might be a lot of other options out there that could either save you money or get you better benefits, but they won’t tell you what is available, because they don’t sell those plans.

So, who do you talk to?

The best person to talk to you is an Independent Medicare Agent. An independent agent is an agent that will present all of the top plans available to you, and help you choose all the plans that is suited to your needs and make sure that you’re always taken care of. They don’t or won’t leave you high and dry after you turn 65 and will always be of service to you in the future. So, when your plan changes or your premiums go up, then they can help you shop the plans again to make sure you always have the best plan for you.

PACE Development Process

Program of All inclusive Care for the Elderly (PACE)

Successful and efficient development of a PACE programs requires access to in-depth knowledge about PACE program operations, marketing and financing. Prospective PACE providers can benefit enormously from the expertise of existing organizations that have had firsthand experience in the development and implementation of PACE. PACE Technical Assistance Centers (TACs) provide such expertise and guidance. TACs are available to assist prospective providers in building successful PACE programs, taking into consideration a broad range of general as well as program-specific factors.

Across the country, TACs provide support and guidance throughout each phase of the PACE development process.

Organizational Assessment – Decision-making

Program of All inclusive Care for the ElderlyA prospective PACE organization will need to consider a number of critical factors that will impact its decision whether or not to proceed with developing a PACE program. One of the first activities an organization will undertake as a part of this decision-making process is an in-depth assessment of whether the community and the sponsoring organization will be able to support and benefit from the development of a PACE program. PACE TACs conduct organizational and market assessments and assist with the development of a business plan and other materials for presentation to the organization’s stakeholders and governing body. St Paul Center in San Diego California is an example of successful Program of All inclusive Care for the Elderly (PACE) implementation. Learn more: https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/PACE/PACE

Some of the key questions that TACs will address during the assessment process are:

  • Are there sufficient numbers of elderly in the catchment area that meet the organization’s eligibility criteria and are likely to enroll in PACE?
  • What specific external and internal competitive factors need to be considered?
  • What service components must be developed and/or adapted and what are their capital requirements?
  • What are the key initial staff positions and what are the processes and criteria used to fill them?
  • What are the initial start-up costs? Will additional capital be required, and if so, are sources of capital available?
  • At what point is financial break-even anticipated?
  • What financial rate of return can be anticipated when the program is fully operational?

Planning and Development – Enrollment

PACE senior day care centerOnce an organization has decided to proceed with PACE, TACs are available to assist with the initial planning and development of the PACE program, including the development of the PACE senior day care center, hiring and training center staff, start-up and preparation of the PACE Provider Application. TACs also provide ongoing consultation once an organization is fully operational and has begun providing services to participants. TACs provide support through telephone consultation, on-site visits, intensive trainings and resource materials. Find out more here https://www.medicaid.gov/medicaid/long-term-services-supports/program-all-inclusive-care-elderly/index.html

TAC resources and services include:

  • Core Resource Set for PACE (CRSP) – set of operating practice resources for developing organizations.
  • Assistance with preparation of PACE Provider Application.
  • Assistance with facility development -PACE center design, capacity assumptions, equipment needs, etc.
  • Assistance with development of program policy and procedures.
  • Assistance with development of efficient management structure – key staff roles, job descriptions, etc.
  • Service integration training – interdisciplinary team training, service allocation and care planning.
  • Consultation on marketing and census building.
  • Consultation on development of QI program and implementation of QI plan.
  • Assistance with establishment of financial reporting and monitoring systems.
  • Consultation on data collection systems and data collection training.
  • Onsite review of ongoing operations and recommendations regarding potential improvements.