What to avoid
Most coverage mistakes are recoverable. A few are not, and the difference is worth knowing before you act rather than after.
Permanent
If your employer is below the size threshold, Medicare pays first whether or not you enrolled. Claims processed on the assumption Medicare already paid can leave you owing the difference, applied backwards over months. A Part B penalty can also attach and generally stays for as long as you have Part B.
Permanent
There is a period when you first become eligible during which a Supplement must be issued regardless of health. Outside it, an insurer may apply medical underwriting and may decline.
Permanent
A late-enrollment penalty can attach and generally persists. "Creditable" is the operative word — some employer and union coverage counts and some does not, and the plan must tell you which in an annual notice. Keep it.
Hard to reverse
Cancel first and you can create a gap no window will let you close. Enrolling in a replacement usually ends the old plan automatically; manual cancellation is rarely necessary and frequently harmful.
Hard to reverse
The clock generally runs from the qualifying event, not from when you noticed one existed. Miss it and you may wait until the next annual window with nothing in between.
Hard to reverse
Advance credits are reconciled against actual income at tax time. It is arithmetic rather than a penalty, but it arrives more than a year later, long after anyone remembers the conversation.
Fixable
The commonest mistake and the least damaging, because it usually corrects at the next window — unless it costs you a doctor mid-treatment, at which point it stops being fixable.
Fraud
People approaching Medicare eligibility are among the most heavily targeted groups in the country. The calls are professionally scripted, which is why they work. The tells are consistent:
The rule that makes it simple: hang up and call back on a number you found yourself. Not the number they gave you, and not the caller ID, which is trivially faked. Any legitimate organisation is comfortable with this.
Report suspected fraud to1-800-MEDICARE, 24 hours a day, TTY 1-877-486-2048, or to yourSHIP counsellor. You do not need our permission and you do not need to tell us first.
Telephone us and describe it. If it sounds legitimate we will say so, and if it does not we will tell you where to report it.
No obligation. We'll tell you if a free option through Medicare.gov or HealthCare.gov suits you better. Monday to Friday, 9:00am – 5:00pm ET.