An older woman on the phone inquiring about Medicare plans.
An older woman on the phone inquiring about Medicare plans. Credit: Freepik / YuriArcursPeopleimages

As you approach the Medicare golden age of 65, the pressure to choose the right Medicare coverage is a real concern. So many things to keep in mind when choosing a plan. Will your doctors take it? Are your prescriptions covered? What will the copays be? It’s enough to make you want to scream!

We asked five top Medicare insurance agents at ClearMatch™ Medicare which mistakes their new-to-Medicare clients may have made … if they didn’t intervene.

1. My family member/friend told me their plan is the best plan.

“Don’t enroll in a plan because your friend or family member says that they have the plan, and it is the best plan. The plan may work tremendously for that individual who recommended it, but it may not meet what you are looking for,” says licensed Medicare agent Lawrence Yi. He’s been selling Medicare plans at ClearMatch Medicare since early 2020 and relates that no two people’s needs are alike. You need to shop and compare different plans to find the plan that is right for you — not your friend.

2. I don’t need to sign up for a Part D prescription plan.

“I always tell my clients they must get a separate plan for prescription drugs. Original Medicare does not cover drugs,” says Malba Wynn, licensed Medicare insurance agent with ClearMatch Medicare for over eight years. And while enrollment in a Part D plan is not required, you will face a penalty for the amount of time you went without prescription drug coverage for the rest of your life. So, long story short — you must enroll in a Part D prescription plan when you become eligible.

3. I’m not retiring yet, so I’ll stay in my employer plan.

“You should always do a comparison of your group coverage and Medicare,” Iris Nelson advises. Nelson knows all about Medicare plans and has been a licensed insurance agent at ClearMatch Medicare for over five years. “About 70% of the time, Original Medicare combined with a Medicare Supplement plan can provide more coverage at a lower cost than what you have through your employer. ” In this economic climate, not everyone can afford to retire at 65. But staying on your employer plan can cost you more in the long run.

4. Not knowing about a plan’s out-of-pocket maximum.

“When enrolling in a Medicare Advantage plan, be aware of the maximum out-of-pocket for the plan. That is the most you will pay in copays for hospital and medical expenses for the year,” notes Marcy LePage, ClearMatch Medicare licensed insurance agent for over 4 years. “It’s important that you know the max money you will pay if you are having a bad health year.” For example, if a plan’s out-of-pocket maximum is $6,000, you will need to spend that much in copays, deductibles and coinsurance for covered services before the plan pays 100% for costs for covered benefits. Just a side note: there is no maximum out-of-pocket with Original Medicare.

5. I can find a Medicare plan without anyone’s help.

“Many people try to learn Medicare on their own, which is great. But you should go over all your Medicare options with a licensed agent whose expertise is in Medicare,” says Joellen Ampagoomian, licensed Medicare agent at ClearMatch Medicare for eight years. “There are so many types of Medicare coverage: Supplements, Medicare Advantage plans, drug plans, dental, cancer, etc. Not all plans are made for everyone. It’s important to know all of your options when you are first enrolling, since your flexibility to make changes in the future may be limited.”

If you are new to Medicare, or just want to speak to someone about your Medicare options, the caring and knowledgeable agents at ClearMatch Medicare are licensed to sell plans from most of the top carriers in the U.S. Give them a call toll-free 1-888-921-1288/TTY: 711, Monday-Friday, 9:00 a.m.-9:00 p.m., and Saturday, 9:00 a.m.-3:00 p.m. (EST). You can also visit www.clearmatchmedicare.com 24/7 and compare plans online.