Common Medicare Myths Debunked: What You Should Know

Despite its importance, Medicare can be a confusing topic. With deductibles, annual premiums, enrollment periods, qualifications, and more, there is a lot of information to keep track of, which can feel overwhelming. Sometimes, essential information falls through the cracks. Other times, correct information gets misconstrued and becomes widespread misinformation, creating even more confusion about what’s true and untrue about Medicare. There are real-world consequences for following Medicare myths, such as unexpected costs [1], late enrollment penalties [2], and delayed care [3]. Today, we’ll be debunking common myths to ensure that you feel confident in your knowledge about Medicare.

Top Medicare Myths that Cause Confusion (And the Facts That Debunk Them)

Myth 1: Medicare is free

Although Medicare is designed to reduce the costs of healthcare services for seniors, no part of Medicare is completely free [4]. The costs for each Medicare plan and part differ, which is why it’s important to understand your options and compare plans based on your individual circumstances. However, the common costs of Medicare are broken down into premiums, deductibles, and copays. A premium is the cost you pay monthly to receive your Medicare plan benefits [5]. A deductible is the amount of money you pay annually for Medicare to begin paying for your healthcare services [6]. Finally, a copay is a pre-determined cost of services that you must pay for Medicare to cover the rest [7].

There are also some “hidden costs” of Medicare that you may easily overlook. For example, Medicare Advantage plans offer lower monthly premium costs, but often have higher out-of-pocket costs [8]. Before choosing a plan, review all the costs and speak with a Medicare professional to clear any confusion.

Myth 2: Medicare covers everything

Despite popular belief, Medicare does not cover everything. Depending on the plans you choose, certain services, providers, and medications may not be covered at all. Original Medicare, consisting of Part A and Part B, typically covers hospital care, doctor’s visits, medical tests, and preventive services [9]. Enrolling in supplemental coverage, like Medigap or Medicare Advantage plans, may offer additional benefits, like prescription drug coverage or lower out-of-pocket costs, depending on the plan.[10].

Myth 3: You can enroll anytime

Although special enrollment periods may open for eligible individuals with qualifying life events [11], there are set enrollment periods for Medicare. The Initial Enrollment Period, which is for individuals who are enrolling in Medicare for the first time, is open during the 3 months before they turn 65 years old, up until 3 months after the month they turn 65 [12]. For existing Medicare beneficiaries, the annual Open Enrollment Period in which they can switch plans takes place October 15-December 7 [12].

Unfortunately, missing deadlines and enrolling late can result in penalties, like additional payments [13]. Mark your calendar for your appropriate enrollment period to ensure you don’t miss it!

Myth 4: Medicare D isn’t worth it if you’re healthy

This couldn’t be further from the truth! Part of being healthy is actively maintaining your health, and for older adults, this often means taking medications as prescribed to control chronic conditions. Medicare Part D helps reduce the costs of medications [14] so that seniors can maintain their health without worrying about finances.

Although Part D is optional, many people choose to enroll so they’re prepared if their medication needs change over time. Even if you don’t take any prescribed medications at the moment, you should still enroll in Part D in case your doctor prescribes you medications later on. Make sure to enroll in Part D during your enrollment period, or there may be late penalties [15].

For help navigating your comparison, use the Medicare “Compare Plans” tool.

Myth 5: You don’t need to review your plan annually

Many individuals believe that once they choose their Medicare plan, they are set for life. Although you are certainly allowed to stay on the same Medicare plan, there may be annual changes to plan costs [16] and coverage [17] that may not align with your health needs. This is why it’s essential to review your plan every year and assess it against your current needs. If your plan longer fits your health needs, you may want to explore other options to see what works best for you. Remember, there’s an annual enrollment period for Medicare that you don’t want to miss (to avoid late penalties). Mark this period on your calendar and set reminders to review your plans and make a potential change during this time.

How to Spot and Avoid Medicare Misinformation

Misinformation can spread quickly, especially when it comes to a topic as detailed and misunderstood as Medicare. This is why you should always check the source from which you are receiving information about Medicare. Are you hearing information from friends, unreliable online forums, or outdated websites? Verify these claims using reputable Medicare websites, such as the official Medicare site’s resources and information page.

Reliable Resources for Medicare Recipients During Open Enrollment

If you have questions about Medicare that aren’t answered on the resources and information page, it’s worth it to get personalized support through a Medicare broker. Medicare brokers can explain plan options and help guide you through the enrollment process so you can make decisions with confidence [18]. Before seeing a broker, make a list of questions to get the most out of your conversations. Consider topics that cause confusion or concern so they can help support you and guide you toward enrolling with confidence.

Build Confidence in Your Medicare Knowledge

Hopefully, these explanations cleared up some of the most prominent Medicare myths and helped you feel more confident about your Medicare knowledge. It’s always recommended to fact-check claims about Medicare by using the official website for reference or speaking to a broker. Seeking education in decision-making will help you feel more clear-headed and confident about Medicare enrollment and plan options, which may otherwise feel a bit overwhelming. With some effort and time, you’ll feel empowered and well-informed in your coverage decisions. For extra help and support on Medicare, visit Greater Good Health’s Medicare information page, or contact us today. You’ve got this!

The information shared is for educational purposes only and is not affiliated with or endorsed by the Medicare Program. For more information, visit www.Medicare.gov

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