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5 Common Misconceptions About Medicare

Senior couple talking with medical professional

If you are newly eligible for Medicare and navigating the territory for the first time, you know how complicated the subject can be. Although there is an abundance of material out there, it is not always accurate and may only add to the confusion. The following are five common Medicare myths debunked:

Medicare Is Part of Social Security

This is not correct. Social Security and Medicare are two separate government programs. The main thing they have in common is that eligibility is associated with age. Under normal circumstances, the earliest a person becomes eligible for Social Security benefits is age 62. Medicare eligibility begins at age 65. However, people who are already receiving Social Security benefits are automatically enrolled in Medicare when they turn 65.

There Is No Cost for Medicare Coverage

This is a false statement. Although Medicare Part A (hospitalization) is free for most people, you will have to pay a monthly premium for Medicare Part B (medical insurance). Together, Parts A and B are known as Original Medicare. If you choose a Medicare Advantage plan (Part C), you will first need to sign up for Medicare Parts A and B and pay a Part B premium. Some Medicare Advantage plans require additional premiums, although many do not.

It Doesn’t Matter When I Enroll in Medicare

You can only enroll in Medicare during specific timeframes, and it does matter when you enroll. If you are already receiving Social Security benefits, you will be automatically enrolled in Medicare at age 65. If not, you need to sign up for it.

Your initial Enrollment Period (IEP) is a seven-month window including the month of your birthday, the three months before, and the three months after. For example, if your birthday is in April, your IEP runs from January through July of the year you turn 65. If you fail to enroll during this window, you may pay higher premiums. The longer you wait to enroll, the higher your premiums may be.

Medicare Advantage Plans Cost More Than Original Medicare

This is a myth. Whether you choose a Medicare Advantage plan or Original Medicare, you will pay Medicare Part B premiums. Many Medicare Advantage plans require no additional premiums. With these plans, there are limits on how much you pay in out-of-pocket covered medical expenses per year, unlike Original Medicare. Some Medicare Advantage plans may offer benefits Original Medicare does not, such as routine dental, vision, hearing, and fitness.

Medicare Covers All Your Medical Expenses

Original Medicare only covers a portion of your medical expenses. The annual deductible is $226 in 2023. Once you meet the deductible, you pay 20% of the costs of seeing a doctor. If you are admitted to a hospital in 2023, your deductible is $1,600. With Original Medicare, unlike Medicare Advantage Plans, there is no limit on your out-of-pocket costs in any given year. For this reason, many people who have Original Medicare purchase Medigap coverage.

If you find the process of enrolling in Medicare complicated and confusing, you are not alone. Our friendly agent is happy to help.