If you're caring for a senior loved one, Medicare can feel like a maze—full of fine print, confusing options, and decisions that carry big consequences.
And the truth is, even smart, well-intentioned caregivers often make missteps that cost time, money, and peace of mind. Let’s walk through the 5 most common mistakes people are making with Medicare in 2026—so you don’t have to.
1. Canceling Medicare Advantage Before Confirming Eligibility for Original Medicare
It might seem like a good idea to switch plans if your current coverage isn’t working. But here's the catch: if you cancel your Medicare Advantage plan, you may not automatically qualify for Original Medicare with supplemental coverage (Medigap). Many people assume they can just "go back" to Original Medicare whenever they want. That’s not always the case.
In fact, unless you're still within your 6-month Medigap Open Enrollment window or qualify for a Special Enrollment Period, you could be denied Medigap coverage due to pre-existing conditions or age. So before making any moves, talk to a licensed broker who understands the nuances. This isn’t just about paperwork—it’s about making sure your loved one doesn’t lose access to the care they need.
Tip: Always confirm Medigap eligibility before you disenroll from a Medicare Advantage plan. Don’t leave a gap in coverage.
2. Not Getting a Part D (Drug) Plan
If your loved one takes medication—even just occasionally—you need to consider a Part D plan. Not signing up for one when you’re first eligible could lead to penalties, higher premiums later, or worse—unexpected out-of-pocket costs for prescriptions.
Many caregivers think, "Well, Mom only takes one medication—we’ll skip Part D this year." But here’s the truth: drug needs can change fast, especially for seniors. And without a Part D plan in place, even a short hospital stay or new prescription could lead to a financial surprise.
Plus, not all Advantage plans include robust drug coverage. Some of the newer meds like Ozempic or Eliquis are costly and may not be fully covered under basic plans. You can easily compare which plans cover specific drugs using tools like YouTube's Medicare School or [MedigapCompare.com.
3. Choosing a Plan Without Checking If Doctors Are In-Network
Many people assume that all doctors accept Medicare—but that’s not true for Medicare Advantage plans, which operate more like HMOs or PPOs.
If your senior has a trusted physician or specialist, always check whether they’re in-network for any plan you’re considering. Choosing the wrong plan could mean:
- Losing access to familiar doctors
- Needing referrals for specialists
- Longer wait times for care
And switching mid-year isn’t always an option. Most plans lock you in until the next Open Enrollment unless you qualify for a Special Enrollment Period.
Tip: Before enrolling in any Advantage plan, call your senior’s doctor’s office directly. Don’t rely solely on the plan’s website—it may be outdated.
4. Skipping the Help of a Licensed Healthcare Broker
Too many caregivers try to navigate Medicare alone. It’s no wonder—ads are everywhere, and they all sound the same: “Call now! Get more benefits!” But here’s the truth: those ads are often backed by insurance companies, and the person on the line might be incentivized to steer you toward certain plans.
A licensed healthcare broker works for you, not the insurance company. They can:
- Compare all your options
- Answer your real questions (like: Can I change my plan mid-year?)
- Walk you through what coverage actually looks like day-to-day
And the best part? Most brokers don’t cost you anything—they’re compensated by the carriers. But beware, insurance pay agents double if they push customers to Advantage plans vs Medicare Originals. Ask what their commissions are.
Tip: Find a broker who understands your senior. They’ll consider not just premiums but also copays, provider access, and long-term needs.
5. Thinking the “Giveback” Offers Are Always a Good Deal
Some Medicare Advantage plans advertise a monthly "giveback"—a rebate on your Part B premium. Sounds great, right?
Not so fast. Those plans often come with tradeoffs: higher deductibles, higher copays, fewer covered services, or limited networks. In some cases, that monthly giveback can cost you far more over time.
It’s not that the giveback is bad—it’s that it’s often misunderstood. Don’t trade short-term income for long-term stress. Always compare the total cost of care, not just the headline perks.
In the "Giveback" Advantage program, you receive a card with money added to it each month for 12 months. However, your copays and deductibles may ultimately be higher than the total cost of the money loaded onto the card. It's a chance you take that hopefully, doctor visits will be few and far between.
Common Questions Answered
How do I pick a good drug plan?
Use tools like YouTube's Medicare School (agents are not paid on commissions) or the official Medicare Plan Finder to search by your medications. Input drug names like "Ozempic" or "Eliquis" and your pharmacy to compare actual costs. If these 2 drugs are on it, the plan might be a fairly good one. Ask your agent.
Can I change plans anytime?
Not usually. You can only switch plans during Open Enrollment (Oct 15–Dec 7) unless you qualify for a Special Enrollment Period. You might be able to switch plans from January - March, depending on what your switching to. Or, ask your agent.
What does Original Medicare cost in 2026?
The Part B premium is expected to rise slightly again (estimated at around $206/month), with an annual deductible of around $288. Check the [Centers for Medicare & Medicaid Services (CMS)] for official updates. Or, ask your agent.
Are plans different between carriers—or just the price?
Yes, with Advantage plans, the benefits, provider networks, and drug formularies can vary widely even if the premiums look similar. Don’t just compare prices—compare what you’re actually getting.
If you are looking at Original Medicare, like a Plan G or N, all plan benefits are the same. These are set up by Medicare. What is different will be the premiums for each plan based on the insurance company you choose.
