Are you approaching your 65 birthday? There’s a lot of information about Medicare out there. As such, it can be hard to differentiate between fact and fiction. Not to mention, what you don’t know can cost you. That’s why this list of the 11 most common Medicare myths will help you avoid any potential pitfalls.
At Senior Insurance Solutions, I am a licensed and independent Medicare insurance agent. That means I am here to help you enroll in the best plan for your needs. I have years of experience working with individuals to match them with the most appropriate healthcare plans. I can help you explore your options, answer your questions, and provide a unique plan catered for you.
Now, let’s dive into the top 11 most common Medicare myths!
Myth #1: Medicare covers all of your medical expenses
Original Medicare (Part A and B) generally covers a portion of your medical care. You will be responsible for the remaining costs. For example, there are out-of-pocket expenses like copays and deductibles. And depending on which plan you choose, there may be additional fees depending on the medical services you use.
For 2023 Medicare costs, the standard monthly premium amount for Medicare Part B is $164.90. For beneficiaries, the annual deductible for Medicare Part B is $226.
There is also no limit on the amount you will pay out of pocket. There is no coverage for eye and ear exams or prescription drugs in Original Medicare either.
Myth #2: If you have Medicare, you don’t need any other insurance
Original Medicare does not include all medical coverage. To have more comprehensive coverage, you will likely need a Medicare Supplement or Advantage Plan (Part C). These plans are also called “Medigap Plans” and provide additional coverage for services not included in Original Medicare.
For example, prescription drug coverage, dental care, vision care, hearing care, and more are often included in a Medicare Supplement or Advantage Plan. It’s important to note that each of these plans has different coverage and costs, so you need to compare them carefully.
Myth #3: Medicare is free
While there’s typically no monthly premium for Medicare Part A, you may still need to pay for other expenses related to your care. For example, there are deductibles and coinsurance amounts that you will need to pay out of pocket. And if you choose a Medicare Supplement or Advantage Plan, you will also incur additional costs such as premiums and copays.
It’s important to remember that even though Original Medicare is not free, it can help reduce medical costs in the long run by providing coverage for major medical services like hospitalization and doctor visits. Furthermore, enrolling in a Medicare Supplement or Advantage Plan can provide additional coverage that fits your specific needs.
Myth #4: You have to sign up for Medicare when you turn 65
This is not necessarily true. While you can enroll in Medicare during the Initial Enrollment Period (IEP), which is 7 months long and starts 3 months before your 65th birthday, you don’t have to enroll right away. If you’re working and covered under an employer-sponsored health plan, it may be best to wait until you retire before signing up for Medicare.
That said, if you miss the IEP — there is a General Enrollment Period from January 1st through March 31st every year. You may also qualify for a Special Election Period if certain life events occur. It’s best to speak with an experienced agent who can explain all of your options to make sure that you are properly enrolled in the most appropriate plan for your needs.
Myth #5: Medicare is only for seniors
While most Medicare beneficiaries are 65 or older, it’s important to note that younger individuals may also be eligible for Medicare coverage. This includes people with disabilities, such as those who have End-Stage Renal Disease (ESRD) or Lou Gehrig’s disease (ALS).
It’s important to remember that eligibility requirements vary depending on which type of plan you choose.
Myth #6: You are enrolled automatically in Medicare
You are not automatically enrolled in Medicare. You must take action to sign up for coverage when you turn 65. During your IEP, you can start the enrollment process by visiting Medicare.gov or speaking with a Medicare agent.
Myth #7: You can apply for Medicare at any time
You can only apply for Medicare during certain periods of time. The Initial Enrollment Period is 7 months long, starts 3 months before your 65th birthday, and ends 3 months after your 65th birthday.
If you do not enroll in Medicare during the IEP, you can face penalties and late enrollment fees if you miss your enrollment period.
Myth #8: If your spouse has Medicare, so do you
This is not the case. Even if your spouse has Medicare coverage, you must still sign up for coverage if you want to be covered. Each person must apply for their own coverage regardless of whether or not they are married.
Myth #9: All doctors accept Medicare
Not all doctors accept Medicare. Therefore, it’s important to check with your doctor to make sure they accept Medicare. If not, you would be expected to pay out of pocket for any treatments received.
Myth #10: Medicare will notify me when I can enroll
Unfortunately, Medicare does not notify individuals when it’s time to enroll. It is your responsibility to keep track of the dates and times that enrollment begins and you must take action if you wish to be covered.
When you enroll depends on whether you’re working and receive employer-sponsored health insurance or plan on retiring soon.
Myth #11: Medicare Advantage plans are the same as Medicare Supplement plans
Oftentimes, people confuse a Medicare Advantage plan with a Medicare Supplement plan. While both offer additional coverage beyond Original Medicare, there are important differences between the two plans.
A Medicare Advantage Plan is an all-in-one solution that covers hospitalization and medical services as well as other benefits like vision, hearing, dental, and more. A Medicare Supplement plan, on the other hand, is a supplemental insurance policy that helps you pay for out-of-pocket costs associated with Original Medicare, such as copayments and deductibles.
Get Medicare Plan Assistance With Senior Insurance Solutions
It’s essential to have all the facts about Medicare before making any decisions so that you can make an informed choice and get the coverage that you need. Make sure to do your research and speak with an experienced Medicare agent who can help you understand all of the options available to you.
At Senior Insurance Solutions, I can help you understand the different types of Medicare plans and answer any and all questions. Through my experienced advice, I can help you find the best Medicare coverage for your unique situation. Contact me today to get started!
