Avoid These Mid-Year Medicare Mistakes

As we move through the middle of the year, it’s the perfect time to pause and make sure your Medicare coverage is still working for you. Whether you enrolled recently or have been on Medicare for years, mid-year is when small oversights can lead to big costs—or missed opportunities. Here are some of the most common Medicare mistakes people make this time of year—and how to avoid them.

1. Skipping Your Mid-Year Plan Review

Many people assume they’re locked into their Medicare plan until Open Enrollment in the fall. But life changes—so should your coverage. If your health needs, prescriptions, or providers have changed, now’s the time to review your plan and explore options like Special Enrollment Periods that may apply.

Tip: Keep a running list of new medications, doctor visits, or diagnoses. This helps you evaluate whether your current plan still fits.

2. Ignoring Prescription Drug Plan Changes

Even if your Part D plan worked well in January, formularies and pharmacy networks can shift mid-year. That generic drug you’ve been taking might now cost more—or require prior authorization.

Tip: Use the Medicare Plan Finder or connect with us for a free plan review to compare your current drug costs with other options.

3. Missing Out on Extra Help Programs

Many Medicare beneficiaries qualify for financial assistance but don’t realize it. Programs like Extra Help or Medicare Savings Programs can reduce premiums, deductibles, and drug costs—even if you didn’t qualify earlier in the year.

Tip: Visit our resources page to learn more about income-based programs and how to apply.

4. Assuming Your Providers Are Still In-Network

If you’re on a Medicare Advantage plan, provider networks can change without much notice. That favorite specialist or hospital may no longer be covered, leading to surprise bills.

Tip: Before scheduling appointments, check with your plan—or reach out to our Medicare advisors to confirm your providers are still in-network.

5. Forgetting to Document Life Changes

Did you move, lose employer coverage, or experience another major life event? These changes may qualify you for a Special Enrollment Period, allowing you to switch plans outside of the usual window.

Tip: Keep documentation of any qualifying events and contact us to explore your options before deadlines pass.

Final Thoughts

Medicare isn’t a “set it and forget it” system. A quick mid-year check-in can help you avoid costly mistakes, stay ahead of changes, and make sure your coverage still fits your life. If you’re unsure where to start, schedule a consultation with a trusted Medicare advisor at PrimeCare Benefits Group. We’re here to help you make confident, informed decisions—year-round.