There are a lot of Medicare myths out there on the internet.

This is a problem, because millions of people depend on Medicare for health coverage. And these Medicare myths make it harder for them to get the best use out of their Medicare coverage.

As a certified Medicare advisor, my biggest role is to help people understand how Medicare works. This includes making sure they know the facts about Medicare…not the myths.

Here are the eight most common Medicare myths…and the truth:

Myth #1. Medicare is free

If only it was…

There’s no monthly premium for Medicare part A (hospital coverage), as long as you (or your spouse) paid Medicare premiums for at least ten years.

But you’ll still have to pay a deductible, plus a daily copayment if you’re in the hospital for more than 60 days.

Medicare part B (doctor visits) and Medicare Advantage plans both have monthly premiums, deductibles, and copayments.

Since Medicare part B only covers 80% of covered medical expenses, you should consider adding a Medicare Supplement (a.k.a. “Medigap) policy to help with the additional expenses..

Myth #2. Medicare covers everything

There are several things that traditional Medicare doesn’t cover, such as:

• Dental care
• Prescription medicine
• Vision care
• Long-term nursing home stays
• Non-medical home care visits

You can usually purchase separate coverage for these. Also, Medicare Advantage plans may also include coverage for dental, prescription drugs, and other expenses.

Myth #3. Enrollment is automatic

This is only true if you’re already receiving Social Security benefits when you sign up for Medicare. In that case, you’ll be automatically signed up.

If not, you must sign up on your own. The window to sign up starts three months before the month you turn 65 and ends three months after that month. You may face penalties if you sign up late.

To sign up:

• Online: go to the official Medicare website (https://www.ssa.gov/medicare)
• In-person at a Social Security office (it’s a good idea to make an appointment in advance)
• By phone: call Social Security at 1-800-772-1213 (plan to be on hold for a while)

Myth #4. You can change your plan at any time

There are specific open enrollment periods when you can change your Medicare coverage.

However…if you have a Medicare Advantage plan and they drop your coverage, you can change to a different plan. This may happen because you move or your plan no longer offers coverage in your area.

Myth #5. Medicare and Medicare Advantage are the same

They sound similar, but they’re different.

Original Medicare is a government program. It includes Part A (hospitalization) and Part B (office visits).

With Original Medicare, you can see any doctor who accepts Medicare. You may need a Medigap plan to cover extra costs. Also, Part B only covers 80% of office visits.

Medicare Advantage (Part C) is offered by private insurance companies. It replaces both Medicare part A and Part B and may include extras like drug coverage, dental, or vision care.

Most Medicare Advantage plans require you to use in-network providers.

Myth #6. You don’t need any other insurance

Original Medicare doesn’t cover everything. There are deductibles and copayments, plus Part B only covers 80% of approved costs. Part B also doesn’t cover dental, hearing, eye care, or prescription drugs.

Most people with Original Medicare add a Medigap policy, a Part D policy for prescriptions, plus additional insurance for dental and vision care.

Medicare Advantage plans often include dental, vision, and prescription coverage. Policies can vary between companies, so be sure to check the details.

Long-term care insurance is a good idea whether you have Original Medicare or Medicare Advantage.

Myth #7. Only seniors can get Medicare

It’s not just for seniors! Some younger people with disabilities can also qualify. People with certain conditions like ALS or kidney failure can also get Medicare.

Myth #8. You can see any doctor

This depends on your plan.

With Original Medicare, you can see any doctor who accepts Medicare (most providers do, but not all).

If you have a Medicare Advantage plan, you may have to stay in-network or pay significantly more.

Want Medicare Facts? Just Ask!

 There’s a lot of confusion around Medicare. But knowing what’s true (and what’s not) can save you time and money. Take time to explore your options. And don’t be afraid to ask questions or get help!

Questions about Medicare? Email me at scott.goodell@ghstx.com, use my contact form, or give me a call at (832) 773-7981.

Scott Goodell
Goodell Health Services

Disclaimer:
The information provided by Goodell Health Solutions is for general informational purposes only and should not be considered legal, financial, or medical advice. We are licensed Medicare insurance agents, and our role is to help you understand your Medicare options.