Medicare is complicated—your decisions shouldn’t be

If you’re like most people approaching 65 (or helping a parent who is), the flood of Medicare mailers, commercials, and opinions can be overwhelming. Choosing a plan is a big financial and health decision—and getting it wrong can mean higher costs, denied claims, or a plan that doesn’t fit your doctors or prescriptions. At Eagle Group Associates, we help Oklahomans compare options in plain English, check networks and medications, and enroll on time—so your coverage fits your life, not the other way around.

First, a quick Medicare refresher (what you need to know)

Medicare is federal health insurance for most people 65+ and certain younger people with disabilities. It has parts:

• Part A (Hospital Insurance): Inpatient hospital, skilled nursing facility (after a qualifying stay), hospice, some home health.
• Part B (Medical Insurance): Doctor visits, outpatient care, preventive services, durable medical equipment.
• Part C (Medicare Advantage): All-in-one plans from private insurers that bundle Parts A & B, usually include Part D drugs and extras like dental/vision; use provider networks (HMO/PPO).
• Part D (Prescription Drugs): Stand-alone drug plans (if you stay with Original Medicare) or embedded in many Advantage plans.
• Medigap (Medicare Supplement): Private policies that help pay Part A/B deductibles and coinsurance; no networks —see any provider who accepts Medicare.

Enrollment windows to remember:

• Initial Enrollment Period (IEP): Seven-month window around your 65th birthday.
• Annual Election Period (AEP): Oct 15–Dec 7 each year—switch/choose Advantage or Part D for Jan 1 start.
• Special Enrollment Periods (SEP): Triggered by moves, loss of employer coverage, certain plan changes, and more.

Why these mistakes matter (the real-world consequences)

• Financial: Missed deadlines can mean late penalties that last as long as you have coverage. Picking the wrong plan can add thousands in out-of-pocket costs.
• Access to care: The “cheapest” plan isn’t a bargain if your doctor or hospital is out of network.
• Medication disruptions: Choosing a plan without checking the formulary can lead to unexpected drug denials or high copays.
• Stress & lost time: Fixing mistakes after the fact often requires appeals, extra paperwork, and longer waits for care.

The 7 most common Medicare mistakes in Oklahoma (and how to avoid each one)

1) Waiting too long to enroll—or enrolling too early

The mistake: Missing your IEP (or delaying Part B without having qualifying employer coverage) can trigger lifetime penalties. On the flip side, some folks enroll in Part B while still covered by an employer plan and end up paying for overlapping coverage.

How to avoid it:

• If you or your spouse are actively working and covered by a large employer plan (20+ employees), you may be able to delay Part B without penalty.
• If not working (or on COBRA/retiree coverage), enroll in Part B during your IEP to avoid penalties.
• Unsure? We’ll review your employer coverage letter and advise the correct timing.

Oklahoma example:

• Norman teacher retiring in May: She keeps Part A at 65, delays Part B while working, then enrolls in Part B when her school coverage ends—using a Special Enrollment Period to avoid penalties.

2) Picking a plan on premium alone (ignoring total costs)

The mistake: Choosing the lowest monthly premium and then discovering a high deductible, steep specialist copays, or frequent out-of-network bills.

How to avoid it:

• Compare total cost of care: premium + deductible + copays + coinsurance + maximum out-of-pocket.
• If you see multiple specialists or anticipate procedures, a plan with a slightly higher premium but lower out-of-pocket max may save money.

Oklahoma example:

• Edmond couple with heart & diabetes meds: A $0-premium Advantage plan looks great until the insulin tiering and cardiology copays are factored in. A different plan with a $25 premium reduces annual costs by hundreds.

3) Not checking doctors, hospitals, and pharmacies

The mistake: Assuming your favorite doctor or hospital “takes Medicare,” then learning your Medicare Advantage plan’s network doesn’t include them—or that your preferred pharmacy is out of network for Part D.

How to avoid it:

• For Advantage (HMO/PPO), verify each doctor and hospital in the exact plan network —names and locations matter.
• For Part D, confirm your pharmacy is preferred to get the best copays.

Oklahoma example:

• South OKC patient who uses OU Health specialists: We verify the specific plan networks that include those clinics; a similar-looking plan excludes key providers.

4) Skipping a drug comparison (or assuming drugs are covered the same everywhere)

The mistake: Enrolling without running your full Rx list through competing Part D or Advantage plans; later discovering prior authorization, step therapy, or non-formulary status.

How to avoid it:

• Use a Medication (Rx) Lookup to compare tiers, coverage rules, and pharmacy pricing across plans.
• Re-check meds during AEP (Oct 15–Dec 7) —formularies change yearly.

Oklahoma example:

• Mustang retiree on brand-name inhalers: A plan with excellent premiums puts the inhaler on a high tier; switching to a different plan with better tiering saves $1,200/year.

5) Confusing Medigap with Medicare Advantage

The mistake: Thinking Medigap and Advantage are “add-ons.” They’re two different paths:

• Original Medicare + Medigap + (optional) Part D= no networks, predictable cost sharing.
• Medicare Advantage (Part C)= bundled plan with networks, extras (dental/vision/hearing), and an annual out-of-pocket max.

How to avoid it:

• Decide what matters most: provider freedom & predictability(Medigap) or all-in-one convenience & extras(Advantage).
• If you travel often or split time between OKC and out-of-state family, Medigap can be appealing; if you like bundled benefits and a managed network, Advantage may fit better.

Oklahoma example:

• Snowbird splitting time between Yukon and Arizona: Chooses Medigap for nationwide access without network worries.

6) Ignoring Special Enrollment Periods after a move or coverage change

The mistake: Missing the chance to change plans after moving counties, leaving employer coverage, or when your plan’s network shrinks.

How to avoid it:

• When you move(say, from Tulsa to Oklahoma County) or lose employer coverage, you likely get an SEP to switch Advantage/Part D plans to those available in your new area.
• Keep proof of the event (move date, termination letter).
• Ask us to confirm your eligibility window—timelines are tight.

Oklahoma example:

• Del City resident moves to Edmond: Networks and plan availability change. We submit a timely switch so doctors near the new home are in network.

7) Forgetting to review your plan every fall

The mistake: Sticking with the same plan year after year while formularies, networks, and copays change behind the scenes.

How to avoid it:

• During AEP (Oct 15–Dec 7), review your Annual Notice of Change and re-run your doctors and prescriptions.
• If another plan is a better fit for the upcoming year, submit a switch for Jan 1 start.

Oklahoma example:

• Moore resident sees new tiering for blood thinner: A quick AEP review finds a plan with a much lower copay at their neighborhood pharmacy.

Step-by-step: a simple process to get Medicare right the first time

1. List your doctors & clinics(include specialty & location).
2. Gather your medications(name, dose, frequency, brand/generic, preferred pharmacy).
3. Estimate your annual care needs(visits, therapies, expected procedures).
4. Decide your priority: flexibility vs. extras, predictable costs vs. lower premium.
5. Compare plans line-by-line(premium, deductible, copays, max out-of-pocket, networks, drug tiers).
6. Confirm enrollment timing(IEP, AEP, or SEP) and submit the right application.
7. Save documents & plan notices(welcome kit, ID cards, formulary links, ANOC each fall).
8. Set a fall reminder(we can do this with you) to re-check networks and medications during AEP.

Real-world scenarios Oklahomans face

• “I’m turning 65 and still working in downtown OKC.”
  If your employer plan is large and affordable, you may delay Part B and Part D. We’ll document the coverage to avoid penalties and set a future start date when you retire.

• “I take three brand-name meds and see two specialists in Edmond.”
  We’ll prioritize formularies and specialist copays. The “cheapest premium” plan may not be cheapest overall.

• “I travel to see grandkids in Texas all winter.”
  If network access is key, Medigap may fit better than HMO-style Advantage plans. We’ll compare both paths.

• “I just moved from Tulsa to Norman.”
  You likely qualify for an SEP. We’ll switch you into a local network plan that includes your new providers.

Common pain points (and how we resolve them)

• Confusing letters & deadlines: We translate notices and set reminders.
• Pharmacy surprises: We check preferred vs. standard pharmacy pricing, and look for mail-order efficiency.
• Prior authorizations & appeals: We explain the steps and help you talk to the plan or doctor’s office.
• Dental/vision expectations: We clarify what Original Medicare covers (very limited) and show plans with embedded extras or stand-alone options.
• Budget anxiety: We show total-cost scenarios so you’re not guessing what care will cost after enrollment.

How Eagle Group Associates helps (why a local guide matters)

• Personal review of your doctors & meds across multiple plans—no generic, one-size-fits-all advice.
• Clear comparisons of premiums, deductibles, copays, out-of-pocket limits—so you see the real trade-offs.
• Network verification for the hospitals & specialists you already use in Oklahoma City, Edmond, Norman, Moore, Yukon, Mustang, Midwest City & Del City.
• Rx Drug Lookup support to catch tiering and prior authorization before you enroll.
• Enrollment timing & paperwork handled correctly (IEP, AEP, SEP), including document uploads.
• Annual check-ins before AEP to make sure next year’s plan still fits your life.

Our mission is simple: help you make confident choices and keep your healthcare predictable.

Ready to avoid costly Medicare mistakes? We’re here for you.

If you’re approaching 65, comparing Medigap vs. Advantage, or need to change plans after a move or retirement, a quick conversation can save you time, stress, and money.

Call (405) 602-1554 or contact us online to schedule your no-cost Medicare review. Bring your doctor list and medications—we’ll do the heavy lifting.

Eagle Group Associates proudly serves Oklahoma City and surrounding communities, including Edmond, Norman, Moore, Yukon, Mustang, Midwest City, Del City, and the broader metro area. Whether you prefer an in-office visit near South OKC or a quick phone appointment, we’ll help you choose Medicare coverage that fits your life here in Oklahoma.