Debunking Myths About Medicare

Published on September 27th, 2021

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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. But if you did not pay Medicare taxes for more than 39 quarters, you pay a premium based on how many months you paid taxes. 

All people pay the Part B premium, which begins at $148.50. 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 Plan A and Plan 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. In most instances, the Social Security Administration automatically enrolls you in Medicare Part A when you turn 65 through.

However, you are responsible for enrolling in everything else, including Part B (medical insurance), 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

True. Medicare Advantage is another option if you want a bundled healthcare services.

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, premium costs vary by income and region. 

Medicare Advantage can save you money. You are limited to a network of doctors and providers for your healthcare. If you travel outside of your assigned area, you have to pay out-of-network prices that may cost more. However, the cost savings could be worth sticking with a network.

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 true. Medicare only pays for medical visits and hospital care.

However, many Medicare Advantage plans cover dental and vision costs in addition to medical services. Plans vary, but some Medicare Advantage plans offer dental benefits up to $2,5000 each year for in-network dentists. 

Neither Original Medicare nor Medicare Advantage offer hearing benefits. You pay out-of-pocket. But you can get discounts through associations that offer seniors lifestyle benefits. 

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 annual enrollment period. 

You can enroll in a Medicare plan three months prior to your 65th birthday and three months after.

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. Medicare Advantage plans may offer limited benefits.

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 or HealthCare, Inc. 

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