Medicare myths cause costly mistakes for seniors
Medicare is used by nearly 60 million Americans, but there’s still a lot of confusion about how the program works. Commonly repeated myths and misconceptions can lead to costly mistakes for older adults.
To help your older adult get their essential health benefits, we share the truth behind 5 common myths about Medicare.
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 Medicare card in the mail 3 months before their 65th birthday, they need to go and 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.
Each year from October 15 to December 7 is the Open Enrollment Period. During this time, older adults can also renew, change, or enroll into healthcare and prescription drug plans.
Myth 3: Medicare is completely free
Popular belief: Medicare is a government benefit, so seniors don’t have to pay anything. They’ve 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.
Myth 4: Medicare pays for 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 any doctor or facility fees that are not covered.
Myth 5: Medicare & Medicaid are the same thing
Truth: Medicare and Medicaid are two separate programs.
Medicare is for people 65 or older who have paid at least 10 years of social security. Medicaid is an insurance program for low-income people of all ages that’s operated by each U.S. state.
Some people are eligible for both Medicare and Medicaid programs, but they have to apply for each program separately.
Recommended for you:
- Medicare vs. Medicaid: What You Need to Know
- Everything You Need to Know About the New Medicare Card: Key Facts and Scams to Avoid
- Medicare Pays for In-Home Care Under the PACE Program
By DailyCaring Editorial Team
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