7 Common Medicare Myths Busted: What You Need to Know

Signing up for Medicare Once you reach 65 years old, the excitement might not match getting those first Social Security checks, yet it remains quite noteworthy. Medicare will probably take on a crucial role in managing your healthcare expenses for the rest of your life.

It’s understandable if this seems baffling to you. Traditional health insurance has many complexities that can be hard to keep track of, and Medicare adds another layer with its own set of distinctive regulations. These factors may result in significant misunderstandings, such as the following seven common Medicare myths.

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1. You will be automatically enrolled in Medicare through the government.

This might apply to you if you receive Social Security benefits four months before reaching eligibility for Medicare, but this isn’t universal. Individuals who do not get Social Security when they turn 64 and eight months old have to enroll in Original Medicare—Parts A and B—on their own initiative.

If you receive Social Security benefits four months prior to being eligible for Medicare, but reside in Puerto Rico, you might still be required to sign up manually for Medicare Part B. This requirement exists because the authorities will automatically register Puerto Rican inhabitants solely for Part A.

2. You have the option to enroll in Medicare immediately following your 65th birthday.

Your initial enrollment period for Medicare starts three months prior to your 65th birthday and concludes three months afterward. Many individuals register during this timeframe.

If you miss signing up within this period, you might face interruptions in your coverage along with late enrollment fees, typically resulting in higher lifelong premiums. Nevertheless, you could sidestep these penalties if you get insurance via your job until age 65 and then join Medicare immediately after losing that coverage.

3. Medicare does not cost anything for anyone.

If you or your spouse have contributed to Medicare taxes for at least ten years during your working life, you won’t owe a premium for Part A. But individuals who haven't met this requirement will be required to pay premiums for such coverage. In 2025, all Medicare recipients must cover a Part A deductible of $1,676.

For the majority of individuals, Medicare Part B comes with a monthly fee of $185; however, those who earn more may face premiums as high as $628.90 each month. In addition to this, Part B includes a deductible along with copayments. Should you decide to join either a Part D prescription drug plan or a Medicare Advantage plan, keep in mind that they too carry separate expenses.

4. In retirement, Medicare is everything you require.

Original Medicare includes hospital insurance (Part A) and medical insurance (Part B). Part A encompasses costs related to inpatient hospitalizations, skilled nursing facilities, hospices, and at-home health services. Part B funds various services such as outpatient treatments, durable medical devices, and preventative measures.

If you desire prescription drug coverage, you must opt for an additional Part D plan. However, even with this addition, expenses such as dental services, eye care, and hearing aid costs will still be your responsibility unless you decide to buy into either a Medigap or Medicare Advantage program.

5. Medigap is equivalent to Medicare Advantage

Medigap policies, which are referred to as Medicare supplement policies, are designed to fill in the gaps where Original Medicare does not offer coverage. These policies can be bought from an independent insurance provider, and they come with their own set of charges including distinct monthly fees, payments, and deductible amounts separate from those associated with your Medicare plan.

Medicare Advantage serves as an option to the traditional Medicare program, provided by private insurance companies. These plans cover all the benefits included in original Medicare and might offer additional perks too. By choosing this path, you will manage just one premium payment along with a single deductible. However, your choice of healthcare providers typically becomes limited to those within the Medicare Advantage plan’s network.

6. You can skip Part D if you aren't taking any drugs consistently.

Although a Medicare Part D plan may particularly benefit older adults who regularly use prescription drugs, it could also be advantageous even if you currently do not require them. Unexpected needs for temporary medication or the onset of chronic conditions requiring ongoing treatment might arise at any point. Enrolling in a Part D plan ensures that you will have assistance with covering such expenses should they occur.

Part D plans may also shoulder the expenses for specific preventive measures, such as vaccinations, which can assist you in warding off illnesses from the start.

7. After enrolling in Medicare, you remain with your selected plan indefinitely.

Each year, there is an Open Enrollment Period lasting from October 15 to December 7. Within this timeframe, you have the option to change from a Medicare plan to a Medicare Advantage plan or make the opposite transition. Additionally, you may opt for a different Medigap or Part D plan. Should you decide to modify your plan during this period, your new coverage will commence on January 1st of the subsequent year.

Should you have any queries regarding your Medicare policy, it’s advisable to get in touch with the Center for Medicare and Medicaid Services. Alternatively, if your plan involves Medicare Advantage or Medigap, you should connect with the respective private health insurance provider to gather further details about coverage options and expenses.

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