10 Costly Medicare Mistakes You Can't Afford to Make

by Danielle Kunkle Roberts

Part D plans also change their benefits annually, which is why so many beneficiaries find Part D to be the most confusing part of Medicare. You’ll need to research your options each fall, but I’m going to show you how to use free resources to help you with this, such as your personal portal at MyMedicare.gov. (In chapter 4, we’ll take a deeper dive into how Medicare Part D works and why this coverage is so important.)

As sure as the leaves change every year so does Part D each Fall.

Chances are good that you will pay nothing for Part A at the time of your enrollment.

Part A cost is based on the number of years worked.

Part A in 2023 will cost you around $506/month. However, people with less than 40 quarters of work experience but more than 30 quarters can get a prorated premium of $278/month.

Here is a price of $506 for 2023 and this will be Free as already stated. That is based on having 40 quaters of FICA. Then there is another option and it is prorated. see page 17.

The base premium for Medicare Part B in 2023 is $164.90 per month. Medicare determines this premium and tends to increase it a bit each year. Part B is a per-person cost, so if you are married, you will each pay your own Part B premium.

Here is the cost of Part B $164.90 times each person covered.

For example, in 2023, Social Security will calculate your Parts B and D premiums based on your 2021 income. Individuals earning more than $97,000 filing individually or $194,000 filing jointly can expect to pay more than the standard base Part B premium. The items that contribute to your MAGI include things like money earned through wages, interest, required minimum distributions from investments, and capital gains. It also includes Social Security benefits and tax-deferred pensions.

The cost of Part B is actually based on income.

For instance, selling property or stock or receiving an inheritance could affect your Medicare Parts B and D premiums that are based on that tax year.

Another catch, the cost is also based on selling property or stocks or getting an inheritance or property or from a portfolio.

Medicare Part B covers only 80% of your outpatient health-care costs. You are responsible for the rest. While paying 20% of the cost of a doctor visit might not hurt too much, imagine paying 20% of the cost of a knee replacement or an open-heart surgery. And that’s not all. You will also be responsible for covering things that fall outside of Medicare but are still health-care related, like dental, vision, hearing, and long-term-care costs.

Dental, vision, and hearing are not covered under Medicare.

supplemental options you have for helping to cover deductibles, copays, and that other 20% of your outpatient expenses.

But how much is the monthly premium for this coverage?

skilled nursing facility (SNF) care. A benefit period begins the day you are admitted to the hospital: as an inpatient or to SNF. It ends when you have left the hospital and go 60 consecutive days without any covered inpatient hospital or SNF care.

Benefits are not based on calender year but on a benefit period which is difined as to the day you begin using the benefit. see page 31

skilled nursing facility (SNF) care. A benefit period begins the day you are admitted to the hospital: as an inpatient or to SNF. It ends when you have left the hospital and go 60 consecutive days without any covered inpatient hospital or SNF care.

see page 31

Part A hospital deductible more than once per year. It is a hefty pill to swallow for many people who are living on a fixed income. However, I’m going to show you later in this book how you can arrange supplemental coverage that will take care of that Part A deductible for you.

There is a suppliment insurance policy to cover hospital deductibles.

To qualify for a Medicare-covered SNF stay, you must first have an inpatient hospital stay of 3 days or longer. Your doctor must order the SNF stay for you. You can’t just elect to go on your own if you want Medicare to cover it.

SNF must be ordered by the doctor otherwise Medicare will not cover it.

Why is that important? Sometimes, hospitals don’t formally admit you into the hospital. Instead, they put you into an “under observation” status. If you aren’t officially admitted into the hospital, then you don’t qualify for SNF coverage even if you were in the hospital for three days.

Wow, that's important to know. The trick is getting the doctor to word it correctly so that Medicare covers those days!

save money by leaving the employer coverage and enrolling in a Medigap plan or a Medicare Advantage plan instead

If the math is done it may be better to drop employer coverage. Avoid- :group plans with high premiums :huge deductibles :$40+ doctor copays You might save significantly on premiums and lower deductibles. Again, you'll want to run the numbers.