A lot of older Americans look forward to their Medicare enrollment because they assume it'll mean affordable healthcare from that point forward. In reality, the costs enrollees face under Medicare can be downright astronomical.
Fidelity puts the average cost of healthcare in retirement at $165,000 for someone aged 65 retiring in 2024. And that’s just an average. If you end up with a lot of health issues as a retiree, your out-of-pocket costs could be higher.
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Thankfully, there are steps you can take to lower your costs as a Medicare enrollee. Here are three strategies to employ.
1. Sign up when you're supposed to
You're not going to be forced to enroll in Medicare when you first become eligible. But if you don't sign up on time, you risk costly surcharges for life. So you may want to play it safe by signing up during your initial seven-month enrollment window. That period starts three months before the month of your 65th birthday and ends three months after that month.
If you delay your enrollment, you could face a 10% surcharge on your Part B premiums for every 12-month period you were eligible for coverage and didn't sign up. So if you're not covered by a qualifying group health plan at the time of your initial enrollment, it makes sense to get Medicare coverage during that seven-month window. A qualifying group health plan is generally one with 20 or more employees.
2. Get prior authorization for Medicare Advantage services as needed
Many seniors choose Medicare Advantage as an alternative to original Medicare, which is Parts A and B plus a Part D drug plan. The upside of Medicare Advantage plans is that they commonly offer supplemental benefits beyond what original Medicare covers, leading to lower costs on a whole.
But one big drawback of Medicare Advantage plans is that they’re notorious for requiring prior authorization for many tests and procedures. And failing to obtain prior authorization could result in your claims being denied and having to pay for certain treatments or diagnostic services yourself.
To avoid that, make sure you know your plan’s rules. And if you’re not certain whether a given test or procedure requires prior authorization, contact your plan and ask the question.
3. Be on the lookout for billing errors
It's not a given that the services your Medicare plan is billed for are the services you actually received. Healthcare billing errors can happen at any time. And if you're not careful, you could end up with higher costs due to something as simple as an office person entering the incorrect billing code.
Before you pay any healthcare bill, check to see exactly what you're being charged for. And if something looks off, contact both your provider and Medicare to dig deeper.
Another thing to consider is that if you have Medicare on top of another insurance, you may get billed for something your primary or secondary insurer was supposed to cover. So in that case, you’d want to contact Medicare plus whoever you get your other insurance from, since sometimes, a lack of coordination between insurances could lead to extra charges for you.
Healthcare is expensive enough as it is, so it pays to do what you can to lower your costs during retirement. Keep these strategies in mind when you enroll in Medicare to alleviate that burden as much as possible.
