Top 10 Medicare Mistakes to Avoid When You Turn 65

Turning 65 is an important milestone, and it often comes with a lot of decisions about healthcare. Medicare is a valuable program designed to help you cover your medical expenses, but navigating it can be complicated. Making the wrong choices can cost you money, coverage, and peace of mind. To help you make the best decisions, here are the top ten Medicare mistakes to avoid when you turn 65.

1. Missing Your Initial Enrollment Period

One of the most common mistakes is missing the Initial Enrollment Period. This period begins three months before your 65th birthday, includes the month you turn 65, and extends three months afterward. Enrolling during this window ensures your coverage starts on time. Missing this period can lead to late enrollment penalties, delayed coverage, and extra costs. It is important to mark this period on your calendar and enroll promptly to avoid unnecessary financial and healthcare complications.

2. Choosing the Wrong Medicare Plan

Medicare offers several options, including Original Medicare, Medicare Advantage, and supplemental plans known as Medigap. Each plan has its own benefits, coverage rules, and costs. Choosing the wrong plan can leave you underinsured or paying more than necessary. Before enrolling, consider your health needs, preferred doctors, and budget. Take the time to compare options carefully and select a plan that fits your current situation and future health needs.

3. Overlooking Prescription Drug Coverage

Even if you do not currently take medications, enrolling in Medicare Part D for prescription drug coverage is essential. Failing to enroll can lead to penalties and higher costs if you need prescriptions later. Prescription drug coverage ensures that you are protected against unexpected medication expenses. Since most seniors rely on prescriptions, having this coverage from the start provides financial security and peace of mind.

4. Assuming Employer Coverage Is Sufficient

If you are still working at 65, it is a mistake to assume that your employer insurance will automatically cover you. For large companies, employer coverage might remain primary, but for smaller employers with fewer than 20 employees, Medicare becomes the primary insurer. Not understanding this can result in gaps in coverage and unexpected medical bills. It is important to confirm your employer’s rules and coordinate Medicare with your existing insurance.

5. Ignoring the Annual Enrollment Period

Many people overlook the importance of the Annual Enrollment Period, which runs from October 15 to December 7 each year. During this time, you can review, change, or update your Medicare coverage. This period allows you to adjust your plan to better suit your changing health needs or to take advantage of new coverage options. Failing to review your plan annually can result in missed opportunities and continued out-of-pocket costs for unnecessary or outdated coverage.

6. Not Understanding Costs and Coverage

Medicare plans have varying premiums, deductibles, and co-pays. Not fully understanding these costs can lead to surprises and budget challenges. Take the time to review plan documents carefully. Compare out-of-pocket costs, coverage limits, and additional benefits. Understanding what each plan covers ensures that you are not paying for services you do not need and that you are fully protected for your healthcare requirements.

7. Overlooking Medigap or Supplemental Insurance

Medigap, or Medicare Supplement Insurance, helps cover costs that Original Medicare does not pay, such as co-pays and deductibles. Not enrolling in Medigap at the right time can result in medical underwriting, which could limit your options or increase your premiums. Typically, the best time to enroll is during the six months after your Medicare Part B starts. Evaluating whether supplemental insurance is right for you can save significant money and avoid gaps in coverage.

8. Failing to Review Prescription Coverage Annually

Even if you enrolled in Part D initially, your plan may change each year. Formularies, premiums, and co-pays can change, affecting your costs and access to medications. Reviewing your prescription coverage annually ensures you continue to get the best plan for your needs. Using tools like the Medicare Plan Finder can help you compare plans, track changes, and make adjustments to avoid unnecessary expenses.

9. Not Considering Future Healthcare Needs

Many people focus only on their current health needs, but planning ahead is critical. Consider potential surgeries, chronic conditions, or future medications. Choosing a plan with comprehensive coverage for anticipated healthcare needs can prevent costly gaps in coverage. Thinking ahead allows you to make smarter choices and ensures that you remain protected as your health needs evolve over time.

10. Falling for Medicare Scams

Medicare scams are unfortunately common, especially targeting seniors. Scammers may call or email asking for personal information or try to sell unnecessary services. Always be cautious and verify any information before sharing personal details. Report suspicious activity to Medicare or the Federal Trade Commission. Protecting yourself from scams is an essential step to safeguarding your finances and personal information.

Conclusion and Call to Action

Turning 65 is an exciting milestone, but it also brings important healthcare decisions. Avoiding these ten mistakes ensures that you get the right Medicare coverage without unnecessary costs or gaps. If you are feeling unsure about your options, visiting Houstonii.com can help. Our team provides personalized Medicare guidance, helping you choose the right plan and giving you confidence in your healthcare decisions. Start today to make your Medicare journey smooth and worry-free.

How to Choose the Right Medicare Advantage Plan in Houston: Top Tips from a Local Agent

Choosing the right Medicare Advantage plan can feel overwhelming, especially with so many options available in the Houston area. Each plan has different benefits, costs, networks, and coverage details—and making the wrong choice could mean higher out-of-pocket expenses or gaps in your health care.

Fortunately, you don’t have to navigate this alone.

At Houston Insurance & Investments, our team of licensed agents—including trusted local advisor Mike Bauer—helps seniors find Medicare insurance that fits their health needs and lifestyle.

Here’s a simple guide to help you choose the right Medicare Advantage plan in Houston, with expert tips from the people who know the local market best.

What Are Medicare Advantage Plans?

Medicare Advantage Plans (Part C) are private health plans approved by Medicare that offer all the benefits of Original Medicare (Part A and Part B)—plus extra perks like dental, vision, hearing, fitness programs, and even prescription drug coverage.

They are offered by major insurance providers and may come in different formats such as:

• HMO (Health Maintenance Organization)

• PPO (Preferred Provider Organization)

• SNP (Special Needs Plan)

These plans are popular for Houston residents who want more coverage flexibility, lower monthly premiums, and added benefits under one plan.

Tip 1: Understand Your Health Care Needs

Not all Medicare Advantage plans are created equal. Start by evaluating your personal health situation.

Ask yourself:

• Do I have any chronic conditions that need specialist care?

• Am I taking multiple prescription medications?

• Do I travel often and need out-of-network flexibility?

• Do I have upcoming surgeries or treatment plans?

Local Insight:

In Houston, many Advantage plans include access to top-rated local hospitals and health systems, like Houston Methodist, HCA, and Memorial Hermann. But network limitations can vary. Choosing a plan with access to your current providers is essential.

Tip 2: Compare Plan Costs Beyond the Premium

Many people look only at the monthly premium, but that’s just the start. Medicare Advantage plans can have:

• Deductibles

• Copays

• Coinsurance

• Out-of-pocket maximums

Pro Tip:

A plan with a $0 premium may end up costing more over time if you have frequent doctor visits or need brand-name prescriptions. Mike Bauer and our team can help you do the full cost analysis—free of charge.

Tip 3: Consider Houston-Area Network Coverage

Many Medicare Advantage plans operate as HMOs or PPOs, meaning your access to care depends on the plan’s provider network.

HMO Plans:

• Require referrals

• Limited to in-network providers (usually no coverage out-of-network)

PPO Plans:

• No referral needed

• Includes out-of-network coverage (at a higher cost)

Local Example:

Some Houston Advantage plans may include access to Kelsey-Seybold Clinic or UT Physicians, while others don’t. Knowing which doctors are in-network helps you avoid unwanted surprises.

Tip 4: Don’t Overlook Prescription Drug Coverage

Most Medicare Advantage plans include Part D prescription drug coverage—but not all drug formularies are the same.

Make sure your medications are:

• Covered under the plan

• In the appropriate tier for affordability

• Easily filled at your preferred pharmacy

Bonus:

Some Houston-area plans offer home delivery, mail-order discounts, or $0 copays for generic drugs. It pays to shop around.

Tip 5: Look for Extra Benefits That Matter to You

One of the biggest perks of Medicare Advantage plans is the added coverage you won’t get with Original Medicare.

Look for plans that include:

• Dental exams and cleanings

• Vision screenings and eyewear allowances

• Hearing aids

• Gym memberships like SilverSneakers

• Transportation to medical appointments

Not all plans offer the same extras, so ask about what matters most to you.

Medicare Insurance That Works for Your Lifestyle

Choosing Medicare insurance is about more than coverage—it's about comfort, trust, and peace of mind.

At Houstonii, we focus on:

• Personalized consultations

• Local plan options

• Annual reviews

• No-cost plan comparisons

• Unbiased advice from licensed experts

We serve clients throughout the Houston area—whether you’re new to Medicare, switching from Original Medicare, or exploring your annual enrollment period options.

Ready to Find the Right Medicare Advantage Plan in Houston?

If you’re feeling overwhelmed by Medicare options, don’t worry—we’re here to help.

Visit our Houston office

Call us to schedule your no-obligation consultation

Book an appointment during Open Enrollment or any time you qualify for a special enrollment period

Call Mike Bauer at Houstonii today.

Let’s find a Medicare Advantage plan that’s right for your health—and your wallet.

Final Word

Choosing the right Medicare Advantage plan doesn’t have to be stressful. With the help of a local Medicare insurance agent, you can confidently compare plans, costs, networks, and extras to make the right choice for your needs.

At Houston Independent Insurance, we’ll walk you through the process—from research to enrollment. No pressure. No cost. Just expert support.