The Biggest Medicare Mistakes to Avoid (A Grosse Pointe Agent's Perspective)

If you live in Grosse Pointe or anywhere across Metro Detroit, navigating Medicare can feel overwhelming. The rules are dense, the deadlines are unforgiving, and a single misstep can cost you for the rest of your life. The most common Medicare mistakes come down to a handful of avoidable errors: missing key enrollment deadlines, mishandling the transition from employer coverage, letting your Medigap window slip by, picking a plan on price alone, and forgetting to review your coverage every year.

Here's what to watch for.

Enrollment and Timing Mistakes

• Missing your initial window. Everyone gets a 7-month Initial Enrollment Period centered on their 65th birthday. Skip it, and you can get hit with permanent late-enrollment penalties on both Part B and Part D that follow you for life.
• Getting employer coverage wrong. If you're still working, timing depends on the size of your employer. With a large group plan (20 or more employees), you may not need Part B right away. But at a smaller employer (under 20 employees), Medicare usually pays first, and failing to enroll on time can leave you with a costly gap.
• Letting the Medigap window close. You get a 6-month open enrollment period for Medicare Supplement coverage once you're 65 and enrolled in Part B. Wait too long and insurers can use medical underwriting to deny you or charge you more based on your health history.

Coverage and Cost Mistakes

• Shopping on premium alone. A $0 or low-premium Medicare Advantage plan can look great until you factor in deductibles, copays, and out-of-pocket maximums. The cheapest premium isn't always the cheapest plan.
• Ignoring provider networks. Don't assume your doctor or preferred Grosse Pointe area hospital takes every plan. Skipping the network check can lead to surprise out-of-network bills.
• Overlooking drug coverage. Your specific medications may not be covered under a given Part D plan, and formularies change every year. What worked last year may not work this year.
• Skipping the annual review. Plans auto-renew, but benefits, drug costs, and network rules shift. Read your Annual Notice of Change (ANOC) so you're not caught off guard in January.

The Bottom Line for Grosse Pointe Residents

Making the right Medicare decision starts with having the right information for your specific situation. And once you've chosen a plan, reviewing it every year is just as important as picking it in the first place.

My consultation services are always free of charge. Give me a call to set up a phone conversation, or if you prefer, a video meeting over Zoom or Microsoft Teams.

Remember: you need the right plan, at the right time, for the right reason.

Frequently Asked Questions

When should I enroll in Medicare to avoid penalties?

Your Initial Enrollment Period is a 7-month window that starts three months before the month you turn 65 and ends three months after. Enrolling in the first three months means your coverage can start the month you turn 65 with no delay. Miss this window without qualifying coverage and you can face permanent late-enrollment penalties on Part B and Part D.

How much is the Medicare late enrollment penalty?

The Part B penalty adds 10% to your monthly premium for every full 12-month period you could have enrolled but didn't, and you pay it for as long as you have Part B. The Part D penalty adds 1% of the national base premium for each month you went without creditable drug coverage, and it also lasts for life. Both penalties are recalculated as the base premiums change each year.

I'm still working at 65. Do I need to enroll in Medicare?

It depends on your employer's size. If your (or your spouse's) employer has 20 or more employees, the group plan usually pays first and you can delay Part B without penalty while you keep that coverage. If the employer has fewer than 20 employees, Medicare typically pays first, so you generally need to enroll in Parts A and B on time to avoid gaps. When the job or coverage ends, you get an 8-month Special Enrollment Period to sign up for Part B.

What is the Medigap open enrollment window and why does it matter?

Your Medicare Supplement (Medigap) open enrollment period is a 6-month window that begins the first day of the month you're both 65 and enrolled in Part B. During this time, insurers can't deny you or charge you more based on your health history. Miss it and you may have to go through medical underwriting, where a company can decline you or raise your premium.

Is a $0 premium Medicare Advantage plan really free?

Not exactly. A low or $0 monthly premium doesn't account for deductibles, copays, coinsurance, and out-of-pocket maximums. Two plans with the same premium can cost very different amounts depending on your doctors, prescriptions, and how often you need care. It's worth looking at the full picture, not just the premium.

Do I need to review my Medicare plan every year?

Yes. Plans change their benefits, drug formularies, and provider networks annually. Each fall you'll receive an Annual Notice of Change (ANOC) explaining what's changing for the coming year. Reading it, or having an agent review it with you, helps you catch increases or coverage losses before they affect you in January.

Do you help with Medicare in Grosse Pointe?

Yes. I work with individuals and families across Grosse Pointe and Metro Detroit, comparing Medicare, Marketplace, and off-exchange health plans. Consultations are always free, by phone or video.