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Next Gen Econ > Debt > Are You Losing Out Because of Medicare Open Enrollment Mistakes?
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Are You Losing Out Because of Medicare Open Enrollment Mistakes?

NGEC By NGEC Last updated: October 13, 2025 6 Min Read
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Every fall, millions of seniors have the chance to review and update their Medicare coverage—but many don’t take full advantage of it. The Centers for Medicare & Medicaid Services (CMS) reports that nearly 7 in 10 beneficiaries stick with the same plan year after year, even when cheaper or better options are available. Medicare Open Enrollment runs from October 15 to December 7, yet confusion about rules, deadlines, and coverage details often leads retirees to overpay or lose benefits. Here are the most common mistakes that quietly cost seniors money—and how to avoid them.

Not Reviewing Prescription Drug Coverage Annually

Drug plans change every year, often without clear notice. The Kaiser Family Foundation (KFF) found that nearly half of all Medicare Part D participants could save hundreds annually by switching to a plan that better matches their prescriptions. Formularies—the list of covered drugs—frequently update, meaning a medication you rely on may no longer be fully covered. Reviewing your plan’s drug list each fall ensures you aren’t paying out of pocket for something that was once included. Even a quick check can prevent big surprises at the pharmacy.

Ignoring Medicare Advantage Plan Changes

Medicare Advantage plans are popular for combining hospital, medical, and sometimes dental or vision coverage. But these plans aren’t static. Premiums, provider networks, and copays shift yearly. Read the “Annual Notice of Change” letter sent by your insurer—it details what’s different for the upcoming year. Failing to review this can mean losing access to preferred doctors or paying more for common treatments. If you don’t check, your “trusted plan” could quietly become a bad fit.

Missing the Deadline

The Open Enrollment window is short, and once it closes on December 7, most changes are locked in until next year. The Medicare.gov site allows beneficiaries to compare plans, estimate drug costs, and submit changes online—but procrastination remains a top reason for missed savings. Those who forget to switch plans must usually wait until the next enrollment period unless they qualify for a special exception. Marking reminders or working with a Medicare counselor early can prevent last-minute stress and costly lapses.

Overlooking Out-of-Pocket Limits and Deductibles

Many retirees focus only on premiums, but that’s not the full picture. High out-of-pocket maximums can make a low-cost plan more expensive in the long run. Check annual caps, copays, and coverage gaps—especially for hospital stays and prescriptions. Seniors who rarely visit doctors often choose the cheapest plan, only to face sticker shock during a medical emergency. A better strategy is balancing monthly affordability with predictable protection.

Failing to Compare Medigap Options

For those on Original Medicare, supplemental Medigap policies help cover costs like coinsurance and deductibles. However, premiums vary widely between insurers offering identical coverage. According to the National Association of Insurance Commissioners (NAIC), comparing at least three quotes before renewing can save hundreds each year. Some states also offer open enrollment protections allowing seniors to switch plans without new medical underwriting. Shopping around annually ensures you’re not overpaying for the same coverage.

Not Checking for New Benefits or Subsidies

Many retirees miss out on programs that could lower costs or expand coverage. The Social Security Administration (SSA) runs the “Extra Help” program for prescription drug assistance, while some states offer Medicare Savings Programs that pay premiums for low-income beneficiaries. Even if you didn’t qualify last year, changing income or expenses could make you eligible now. Reviewing financial assistance options annually ensures you’re not leaving valuable benefits on the table.

Relying on Outdated or Incomplete Advice

Well-meaning friends, relatives, or even past insurance agents may not have the latest plan data. Medicare coverage is highly regional—what works in one state might not in another. The State Health Insurance Assistance Program (SHIP) offers free, unbiased counseling from certified Medicare experts. They can explain differences between Advantage, Part D, and Medigap plans and help compare prices in your ZIP code. Relying on current information from trusted sources is the best way to protect your coverage.

Taking Control Before the Deadline Hits

Medicare Open Enrollment is your annual chance to protect your health—and your wallet. Ignoring it means leaving money and care options on the table. Reviewing your plan’s fine print, comparing updated options, and verifying coverage before December 7 can make the difference between confidence and costly regret. The smartest retirees treat enrollment season as a yearly checkup for both their healthcare and finances.

Have you ever switched Medicare plans and saved money—or regretted not doing so? Share your story in the comments to help others prepare before the deadline.

You May Also Like…

  • How to Make Medicare Advantage Work Better Than Original Medicare
  • Medicare Might Deny Eyeglasses Even After Cataract Surgery in Many States
  • Free Wellness Visits Under Medicare Aren’t Always Free
  • How New Prescription Drug Pricing Laws Will Affect Older Adults
  • Are You Overspending on Prescription Drugs Without Realizing It?

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