Debunking Myths About Medicare

Contrary to popular belief, the cost of living doesn’t get cheaper once you turn 65. Sure, you begin to reap the benefits of Social Security and Medicare. But you may be surprised to learn some myths on aging and health benefits (e.g. Medicare is free”) are not true. However, you can take control of your financial responsibilities before you age on to Medicare and properly prepare yourself for the best years of your life.

Article Highlights

Myths about Medicare abound. It’s difficult to know what’s accurate.

Learn about the differences between Original Medicare and Medicare Advantage.

We outline what Medicare does AND does not cover.

Learn about extra health services available on certain plans.

Myth #1: Medicare Is Free

Partly true. Most people don’t pay a monthly premium for Medicare Part A — that requires 40 quarters (10 years) of Medicare-covered work. If you have 30–39 quarters, you pay a reduced premium ($311/month in 2026); with fewer than 30 quarters, the premium is $565/month in 2026.

All people pay the Part B premium, which is $202.90/month in 2026. Note: it can be higher based on your income.

If you want Part D prescription coverage, you’ll pay an additional premium, which varies by plan and income level.

Myth #2: Medicare Has No Deductibles

False. Medicare pays about 80% of your total medical costs. But you are responsible for Part A and Part B deductibles and other charges outside of the maximum benefits.

If you want to cover this coverage gap, you can enroll in a Medicare Supplement plan, also known as Medigap. Some Medigap policies pay for deductibles and other excess charges and coinsurance. Premiums vary based on what plan you select and where you live.

Myth #3: You Automatically Enroll in Medicare at 65

Partly true. If you’re already receiving Social Security or Railroad Retirement Board benefits before you turn 65, the Social Security Administration automatically enrolls you in Medicare Part A (and Part B) starting the month you turn 65. If you haven’t yet claimed Social Security by then, you’re not enrolled automatically — you need to sign up yourself.

Either way, you are responsible for enrolling in everything else, including Part D (drugs) and any additional supplemental insurance plan.

Myth #4: Medigap Plans Are Expensive

It depends. Medicare Supplement or Medigap plans offer a wide range of benefits.

If you have a limited budget, check out Plans A or B. They don’t pay skilled nursing facility coinsurance or foreign travel. But if you don’t anticipate needing that type of benefit, either plan could be an option.

The more important thing to do is shop around for coverage that makes sense for your health today and your wallet.

Myth #5: Medicare Advantage Is Always Cheaper

False. Medicare Advantage is another option if you want bundled healthcare services, but “always cheaper” isn’t accurate — it depends on your plan and how much care you use.

It includes Part A, Part B, prescription drug coverage, and extras like dental and vision insurance all on one plan. Since private insurance companies offer Medicare Advantage, premiums, provider networks, and out-of-pocket costs all vary by plan and region.

Medicare Advantage plans often have low or $0 premiums, which is where the “cheaper” reputation comes from. But you’re generally limited to a network of doctors and providers. If you travel outside of your assigned area, you may have to pay out-of-network prices that cost more — and if you end up needing a lot of care in a given year, your total out-of-pocket costs can end up higher than they would have been under Original Medicare plus a Medigap plan. It’s worth comparing your specific health needs against a specific plan rather than assuming Medicare Advantage wins on cost.

Myth #6: Medicare Includes Prescription Drug Coverage

False. Original Medicare doesn’t automatically come with drug benefits. If you have Original Medicare, you have to enroll in Part D for prescription drugs with a private insurance company. That is billed separately.

Medicare Advantage plans typically cover prescription drugs as part of your complete bundle of services.

Once you decide on the Original Medicare or Medicare Advantage route, you can make an additional drug coverage purchase as needed.

Myth #7: Medicare Doesn’t Cover Dental, Vision And Hearing Benefits

Partially true. Under Original Medicare, this is mostly true — routine cleanings, exams, X-rays, dentures, eyeglasses, and hearing aids are not covered. There’s one narrow exception: since a 2023 CMS rule (expanded further since), Original Medicare will cover medically necessary dental care tied to specific medical treatments, such as before an organ transplant or cardiac valve procedure, or during head/neck cancer treatment or dialysis. That’s a small carve-out, not general dental coverage.

Many Medicare Advantage plans cover dental, vision, and hearing costs in addition to medical services — these are among the most common supplemental benefits MA plans offer. Dental caps vary a lot by plan; most run in the $1,000–$1,500 range per year, though some higher-tier plans offer up to $2,500 or more for in-network dentists.

If you stick with Original Medicare and want hearing or vision coverage, you’ll generally pay out-of-pocket, though you can find discounts through associations that offer seniors lifestyle benefits, or add a Medicare Advantage or standalone dental/vision/hearing plan.

Myth #8: I Can Enroll In Medicare or Change My Plans at Any Time

False. There are actually steep penalties if you don’t enroll during the proper Medicare enrollment period.

Your Initial Enrollment Period runs seven months: three months before your 65th birthday month, your birthday month itself, and three months after. As of a rule change effective 2023, coverage now starts the first day of the month after you enroll, no matter which month of that window you sign up in — it’s no longer delayed by enrolling later in the window.

Once that window passes, you have to wait until the annual enrollment period (October 15–December 7 every year) to change your Original Medicare plan and any supplemental insurance coverage.

If you have a Medicare Advantage plan or wish to enroll in a different plan or switch back to Original Medicare, that annual enrollment period is Jan. 1–March 31 every year.

Myth #9: Medicare Pays for Medical Expenses in a Foreign Country

False. Original Medicare does not pay for medical expenses you incur when you travel in a foreign country and need care, with only a few narrow exceptions (for example, if a foreign hospital is genuinely closer than the nearest U.S. hospital for a specific emergency). Some Medicare Advantage plans offer limited worldwide emergency coverage as a supplemental benefit, but that varies by plan and isn’t guaranteed.

If you are a worldly traveler and plan to spend retirement overseas from time to time, many Medigap plans offer coverage for treatment and transportation. You can also purchase travel insurance to protect yourself too.

Next Steps

The bottom line when shopping for Medicare is to investigate your options.

Compare Original Medicare to Medicare Advantage in your area.

If you live in an area that would have a large network of doctors and hospitals available to you, Medicare Advantage could be an affordable option with extra added benefits like dental and vision.

If you live in a more rural setting where finding a network physician close by may be more of a challenge, Original Medicare with a Medigap plan may be the better fit.

Turning 65 shouldn’t be a chore; neither should your search for healthcare. Medicare gives you plenty of time to look at your options and adjust later if your needs change. You can always find savings if you take the time to investigate what’s best for you.

The views and opinions expressed are those of the authors and do not necessarily reflect the official policy or position of HealthCareInsider.com or HealthCare, Inc.