Myth's about Medicare

Until you’re eligible for Medicare, it’s easy to ignore it. The Medicare system can be a bit overwhelming. It’s no wonder there are so many misconceptions floating around out there.

Myth: I can sign up for Medicare anytime.

Some people get confused when it comes to signing up for Medicare. It’s easy to think that once you turn 65, you can enroll anytime. Not true.

In Truth: You are only able to sign up for Medicare coverage at certain times of the year unless you qualify for a special election.

The moment you are eligible to sign up for Medicare is three months prior to your 65th birthday. It’s important that you sign up early to make sure your coverage starts the month of your birthday. If you don’t sign up within three months before or up to three months after your birthday, you will have to wait until the Open Enrollment Period at the end of the year (October 15 through December 7).

There are exceptions. If you did not sign up for Medicare when you were first eligible because you were covered by another plan, you can enroll in Medicare within eight months of when that coverage ends (unless your coverage was with a COBRA plan). If you enroll late, you will pay a penalty.

That’s why it’s important to sign up during the designated enrollment periods. There is a lot to know about Medicare and sometimes it can be difficult to understand. Your best bet is to get started early. Visit for more specific enrollment information.

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Myth: Medicare coverage is free of charge.

Even people who don’t believe their Medicare coverage is free often think it will be very reasonable and affordable. All of this is subjective, of course, but most people are surprised by how quickly expenses can add up.

In Truth: First of all, Medicare is not free. While most people earn enough work credit to quality for free Part A, you will have to pay a monthly premium for Part B. The part B monthly premium average is $134 and then you pay an additional 20 percent of Medicare-approved amounts for most doctor services, outpatient therapy and durable medical equipment.

As mentioned previously, there are deductibles for hospitalizations over $1,316 per stay per coverage period. For outpatient services such as doctor visits, lab work and x-rays, and for all the other care you receive, you will pay an additional deductible.

One of the biggest expenses for people with Medicare is prescription drugs. That’s because original Medicare alone provides no pharmacy coverage at all. None. Any Medications you are prescribed, you will have to pay in full or buy a Part D supplement.

You can understand why we say Medicare coverage alone certainly is not free.

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Myth: Because I don’t take medications, I don’t need Medicare Part D coverage.

Medicare Part D is the drug portion of your health care coverage, and you have to sign up to receive it. You may not take medication on an ongoing basis so it’s easy to see why you might decline Part D coverage.

In Truth: You may pay think you’ll just sign up for Part D if and when they need arises. Here’s the problem with that. You may have to pay a penalty if you do not sign up when you are first eligible for Part D coverage.

It’s really best to go ahead and get part D coverage event if you don’t think you need it. By signing up for Part D during open enrollment, you’ll be covered no matter what occurs during the year.

It’s important to note that Part D coverage is usually available and included in the benefits you get with most Medicare Advantage Pans. With all prescription drug plans, cost and benefits vary. Be sure to review all the materials and know the facts before signing up.

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Myth: If I choose a Medicare Advantage Plan, I’ll have to pay big premiums.

Many people with Medicare choose a Medicare Advantage Plan. Other people hesitate to sign up because they are sure a plan with such comprehensive coverage must be expensive.

In Truth: Medicare Advantage Plans typically have a range of premiums to fit your budget. As long as you continue to pay your Medicare Part B, you’re in good shape.

Now, when you sign up with a Medicare Advantage Plan, you agree to receive all your care through the plan. In other words, you’re no longer using your Medicare benefits, but using those of the plan. Your benefits are typically far more comprehensive than what you get with Medicare alone.

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Myth: Medicare Advantage Plans offer less coverage than original Medicare or my employer plan.

Many people believe Original Medicare or their employer plan will provide more coverage than a Medicare Advantage plan.

In Truth: Medicare Advantage plans often have more comprehensive options for coverage than Original Medicare or employer plans alone.

For starters, although there are exceptions, most prescriptions are not covered under original Medicare. While many Medicare Advantage plans cover prescription drugs.

How about employer plans? Some employer plans may cover prescription drugs but their deductibles and copays, along with limited coverage for doctor visits, hospital stays and other health care related expenses, can end up costing you more out-of-pocket than you thought.

So, truth be told, odds are a Medicare Advantage Plan can provide you with more coverage and less out-of-pocket expenses than either Original Medicare or an employer sponsored retiree health plan alone.

Myth: Original Medicare alone is enough.

You may have heard that original Medicare works like a private insurance plan, and you may think it has you covered.

In Truth: Well, this isn’t entirely true. Yes, Medicare helps with major medical expenses such as hospitalizations. But for most Americans over 65, Medicare alone isn’t usually enough.

The reason? There are significant deductibles and out-of-pocket expenses. For example, a hospital visit from 1 to 60 days means a deductible of $1,316 per stay.

And if you don’t require hospitalization, you still pay for all your dental, hearing and routine vision care. Medicare Part B deductible is $183, and then you’re responsible for the 20 percent of all your doctor visits and related expenses.

Importantly, original Medicare covers no prescription drugs at all. However you are required to purchase a Part D plan for prescriptions.

That’s why, for many people, Medicare alone isn’t enough. A lot of people over 65 opt to add the security of a supplemental program or a Medicare Advantage Plan.

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