Medicare for Do-It-Yourselfers: Why Going It Alone Might Cost You More Than You Think

Some people fix their own cars. Others build their own furniture. Some even install their own ceiling fans (fingers crossed).

And then there are the Medicare DIYers—well-meaning folks who decide to figure it all out themselves when turning 65.

We get it. You’ve been independent your whole life. You’ve made big decisions before. How hard could Medicare be?

Truth is, Medicare is one of the most complicated “systems” you’ll ever try to assemble. It comes with parts (A, B, C, D), penalties, timelines, coverage gaps, plan choices, prescription drug rules, income-related costs, and dozens of enrollment paths. And unfortunately, the wrong turn could cost you for years.

This blog is for those of you who are doing your homework, asking the right questions, and trying your best to get it right. We’re not here to criticize—we’re here to help you avoid the most common DIY Medicare mistakes.

One of the biggest myths in the Medicare world is that “there’s one best plan” or “everyone should do the same thing.” That’s simply not true.

Your work status, income level, health conditions, doctors, prescriptions, travel habits, and budget all affect what’s best for you.

Many DIYers read a few blogs or watch a couple YouTube videos and assume they’ve got the full picture. But those general guides don’t know:

That your employer coverage ends on your 65th birthday,
That your heart specialist is out-of-network for some Advantage plans,
Or that you’re taking a brand-name medication that’s not covered under certain drug plans.

A licensed Medicare advisor looks at the whole picture.
A search engine just gives you part of it.

Medicare Is Not One-Size-Fits-All

Missing Deadlines = Lifelong Penalties

The Initial Enrollment Period (IEP) starts three months before you turn 65. Miss that? You may owe penalties for:

Part B (medical insurance) – 10% for every year you delay
Part D (prescription drug coverage) – 1% for every month late

If you’re still working, you might be able to delay—but only if your employer coverage qualifies. Many DIYers assume they can wait because they have insurance, only to find out too late that their employer plan wasn’t considered “creditable.”

Professional help costs nothing—and can save you from expensive surprises.

Common Medicare DIY Mistakes

Here are some of the biggest pitfalls we see from Medicare do-it-yourselfers:

Not understanding the difference between Medicare Advantage and Medicare Supplement (Medigap) leads many to enroll in a plan that doesn’t meet their needs—or costs them more in the long run.

Enrolling in the Wrong Plan

Many DIYers pick the cheapest Part D plan—only to find out it doesn’t cover their specific medications, or charges very high copays.

Assuming All Drug Plans Are the Same

As mentioned, penalties are real—and permanent. Even if you’re healthy now, skipping Part D can cost you later.

Missing the Part B or D Enrollment Window

Some people choose a high-premium Medigap plan when they could get the same results with a High-Deductible G or Medicare Advantage plan based on their health history.

Overpaying for Unused Coverage

Plans have different rules when it comes to state-to-state coverage or emergency care when traveling. Not all Advantage plans are created equal.

Ignoring Travel or Snowbird Needs

There’s a Lot of “Medicare Misinformation” Out There

DIYers often turn to:

Their friend down the street (“I heard you just need Plan G and that’s it”).
Their brother-in-law (“I never signed up for Part D and I’m fine”)
Internet forums (“Medicare Advantage is a scam!”)

The truth is, everyone’s situation is different. And what worked for your neighbor might be a poor fit for you.

Worse yet, there’s a lot of outdated info online. Plan benefits, costs, and rules change every year.

You Can Still Be Independent—With a Little Guidance

Let’s be clear: Getting professional Medicare help doesn’t mean you’re giving up control.

Has access to all the current plans in your area
Can run your medications through every plan’s formulary
Knows how your doctor network works
Helps you compare side-by-side costs (premiums, copays, deductibles)

And in most cases, these services are 100% free.
No cost. No pressure. No obligation.

It’s like having a trusted co-pilot who’s flown this route hundreds of times before.

When DIY Might Be Okay

Some people can successfully navigate Medicare alone—usually if:

They’re retiring from a job with a strong HR department
They have very simple health needs
They’ve had Medicare in the family before (spouse, parent, etc.)
They’re very comfortable reading through plan documents

But even then, it’s always worth having someone review your plan—especially in your first year. There’s no downside to a second set of eyes.

Final Thought: It’s Not About Selling, It’s About Solving

You’re not being “sold” when you ask for help.

You’re Making Sure That:

You don’t pay more than you need to
You don’t lose coverage when you need it most
You don’t get stuck in a plan that doesn’t work for your health or lifestyle

And best of all, you can do it with someone who’s licensed, local, and knows the ropes.

You’ll still make all the decisions—just with a clearer view of the road ahead

Choosing the Right Medicare Coverage

Selecting the best Medicare coverage depends on factors like your healthcare needs, budget, and preferred providers. You can choose between:

Original Medicare (Parts A & B): Allows you to see any doctor or
hospital that accepts Medicare but does not include prescription drug
coverage (Part D) or additional benefits.
Medicare Advantage (Part C): Offers bundled coverage with
potential extra benefits but may require using a network of providers.
Medigap (Medicare Supplement Insurance): Helps cover
out-of-pocket costs not covered by Original Medicare, such as
copayments and deductibles.

Key Medicare Enrollment Periods

It is crucial to enroll in Medicare at the right time to avoid penalties and ensure continuous coverage:

Initial Enrollment Period (IEP): A seven-month window starting
three months before your 65th birthday month.
General Enrollment Period (GEP): From January 1 to March 31
each year for those who missed their IEP.
Annual Election Period (AEP): From October 15 to December 7,
allowing you to switch or enroll in Medicare Advantage and Part D
plans.
Open Enrollment Period(OEP): From January 1 to March 31 for
those who missed AEP and want to make certain changes.
Special Enrollment Period(SEP): Can be used anytime during the
calendar year for those that meet certain criteria such as moving to a
new service area.

Finding Help with Medicare

Understanding Medicare can be complex, but you don’t have to do it alone. Licensed Insurance Brokers, Medicare.gov, and state health assistance programs can provide guidance tailored to your specific needs.

By taking the time to explore your Medicare options, you can make informed decisions that ensure you receive the healthcare coverage that best suits your lifestyle and budget.

Do I have to sign up for Medicare?

It depends upon your current coverage. If you are employed and your employer has over 20 employees then you can delay signing up for Medicare and avoid penalties.

Does Medicare cover Prescription Medications?

No, You will have to enroll in a stand alone Part D plan or a Medicare Advantage Plan(Part C) to get coverage.

I want to be able to go to any doctor/hospital, are there networks with Medicare?

There are no networks with Medicare and most doctors and hospitals accept it. However, Medicare does not cover 100% of services so a Medicare Supplement or Medicare Advantage plans is advisable.

Mike Miligi- Owner

For over 10 years, Mike has been assisting Seniors and other Medicare-eligible individuals in understanding the ins and outs of Medicare and Medicare Health Insurance options, including Medicare Advantage Plans(Part C), Medicare Supplement Plans(Medigap), Prescription Drug Plans(PartD), and Dental and Vision programs.

Mike is Licensed in seven States and Certified with 11 Insurance Carriers. He has helped thousands of individuals decide on the best course of action for their particular Health Insurance needs. Because Mike is an Independent Medicare Health Insurance Broker, he works for the client, not the Insurance Carriers, and is able to provide his clients with accurate and unbiased Health Insurance options.

Mike recertifies with CMS(The Centers for Medicare and Medicaid Services) annually, regularly completes Continuing Education Courses required by individual State Insurance Departments, and keeps abreast of industry trends and standards to offer his clients the most up-to-date information.