5 Medicare Myths

medicare myths

Myth 1: Medicare coverage is automatic once you turn 65

Popular belief: Seniors don’t have to do anything, they’ll be covered by Medicare as soon as they turn 65.

Truth: Not everyone will be automatically enrolled in Medicare Part A and Part B. If your older adult doesn’t get a red, white, and blue Medicare card in the mail 3 months before their 65th birthday, they have to go sign up for a Medicare health insurance plan.


Myth 2: Older adults can enroll in Medicare anytime

Popular belief: It doesn’t matter when older adults sign up for Medicare, they can do it anytime and everything will be the same.

Truth: If older adults don’t enroll during the Initial Enrollment Period, they may have to pay higher premiums later.

Seniors are eligible for Medicare when they turn 65 and after they’ve worked for at least 10 years. The best time to enroll is during the Initial Enrollment Period, which starts 3 months before their 65th birthday month and goes until 3 months after their birthday month.

From October 15 – December 7, older adults can also renew, change, or enroll into plans of your choosing once a year during the Open Enrollment Period.


Myth 3: Medicare is completely free

Popular belief: Medicare is a government benefit, so seniors don’t have to pay anything. They already paid for it by paying taxes all those years.

Truth: Even though Medicare is paid for by a tax-funded trust fund, people who have Medicare insurance coverage still have to pay monthly premiums and co-pays for services and prescription drugs.

Many people can qualify for free Part A premiums if they meet certain conditions. Others with low income may be eligible for the Qualified Medicare Beneficiary (QMB) program, which pays for Part A and B premiums. Most people have to pay a Part B monthly premium, except for those in the QMB program.

Aside from the monthly premiums, seniors usually have to pay a co-pay, co-insurance, or deductible. To get quick explanations for these terms, read Medicare Billing Terms You Need to Know.


Myth 4: Medicare covers everything medical-related

Popular belief: No matter what’s needed, as long as it’s related to health or medical care, Medicare will pay for it.

Truth: Medicare Part A and B cover most hospital and medical expenses. Medicare Part C and D cover expenses and services not covered by Part A and B, like prescription drugs and other hospital fees.

But even with all those different parts, older adults still have to pay doctor or facility fees that are not covered.


Myth 5: Medicare & Medicaid are the same

Truth: In general, Medicare is for people 65 or older who have paid at least 10 years of social security. Medicaid is an insurance program that’s operated by each U.S. state. It’s for low-income people of all ages.

Some people are eligible for both Medicare and Medicaid programs. But those people have to apply for each program separately.


Next Step  Check plans during Medicare Open Enrollment, Oct 15 – Dec 7


By DailyCaring Editorial Staff
Image: Acom Health


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