Common Medicare Myths and Misconceptions Debunked

Medicare is used by millions of people across the USA. It’s designed to help provide health cover for those over 65 and also for younger individuals who may have a disability. In the USA alone, there are over 67.3 million people who are enrolled in Medicare. Since the 1970s when $7.5 billion was spent on this program, it has since increased to $1.037 billion spent on Medicare in 2023. 

While it offers great advantages for many people, and can save money in a lot of areas, Medicare is one of the most misunderstood healthcare programs in the USA. In this article we’ll discuss the top four common myths many people believe which aren’t true. Let’s take a closer look. 

Myth 1: Medicare Is Free

While Medicare can provide substantial coverage for individuals, it’s not all free. Here’s some information on the different sections where costs may be involved. 

  • Hospital insurance (Part A): This is generally premium free for those who worked or have a spouse that worked and already paid medicare taxes. This section covers hospice care, some home health services, skilled nursing facility care and inpatient hospital stays. 
  • Medical insurance (Part B): This one requires a monthly premium which is calculated based on your income. It covers outpatient medical services like lab tests, preventive care, and some medical equipment. This is optional coverage. 
  • Prescription drug coverage (Part D): This also requires a premium and out-of-pocket cost which is dependent on the medication covered and the specific plan. This cover helps with the overall costs of prescription medications. 

Medicare isn’t completely free. It’s best to seek professional help for Medicare coverage and advice to make sure you’re on the right plan that suits your individual needs. 

Myth 2: You’re Automatically Enrolled In Medicare 

Unfortunately you’re not automatically enrolled in Medicare when you turn 65. Those already receiving social security benefits may already be enrolled. Some things to remember with enrollment includes: 

  • If you don’t enroll by the initial enrollment period you may experience penalties which in turn can push your premiums up permanently. 
  • If you don’t receive social security benefits at the age of 65, you need to enroll yourself in Medicare. 

It’s important to be proactive about Medicare enrollment to avoid penalties and to ensure you have the right coverage you need. It’s also important for helping to promote quality of life in your senior years with additional healthcare plan options. 

Myth 3: You Can Switch Medicare Plans Anytime

While you do have the option to switch Medicare plans, there are time constraints in order to do this. 

  • The Annual Enrollment Period (AEP) between October 15 to December 7 is the time to Change Part D and Medicare Advantage plans. 
  • SEPs or Special Enrollment Periods are available anytime but require special circumstances like losing another health coverage or moving from your plan’s service area. 
  • Between January 1 to March 31, the Medicare Advantage Open Enrollment Period permits those who are on the Medicare Advantage plan to change plans or return to Original Medicare. 

It’s important to assess plans and understand the legal restrictions and requirements before choosing one so you can change plans if needed during the right enrollment times. 

Myth 4: Medicare Covers Everything 

Many people think Medicare covers all healthcare costs, but unfortunately it doesn’t. 

  • Parts A and B of the original Medicare coverage doesn’t normally cover routine vision care, dental care, hearing aids or other related long term care. Unless you have a major traumatic event, original Medicare won’t cover these costs. 
  • You’re responsible for any coinsurance, copayments or deductibles for a variety of services. 

In order to fill these gaps some people will also take out medigap or Part C Medicare Advantage plans which provide additional coverage. Remember to review your finances to make sure you can cover any costs necessary on premiums. This makes for good savings and debt management. 

Endnote

Medicare is an essential part of the healthcare system. By understanding the Medicare myths you’re able to not only save money in the long run but also navigate your coverage and plan with confidence. Always ask for professional advice if you’re unsure about anything and remember to stay active in order to boost your mental health and well-being.