7 Medicare Myths You Should Know About

Source The Motley Fool

Signing up for Medicare once you turn 65 may not be as exciting as applying for Social Security checks, but it's significant nonetheless. Medicare will likely play an important part in covering your healthcare costs for the remainder of your life.

You're not alone if you find it confusing, though. The ins and outs of traditional health insurance can be difficult to follow, and Medicare's got some unique rules on top of that. This can lead to some costly misconceptions, including the seven Medicare myths listed below.

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Person looking a prescription bottle at kitchen table.

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1. The government will automatically enroll you in Medicare

This may be true for you if you're already receiving Social Security benefits four months prior to becoming eligible for Medicare, but it's not true for everyone. Those who aren't receiving Social Security at 64 and 8 months must actively sign up for Original Medicare -- Parts A and B.

Even if you are on Social Security four months before you're eligible for Medicare, you may still have to actively enroll in Medicare Part B if you live in Puerto Rico. The government only automatically enrolls Puerto Rican residents in Part A.

2. You can sign up for Medicare at any time after you turn 65

Your initial enrollment period for Medicare begins three months before you turn 65 and ends three months after you turn 65. Most people sign up for Medicare in this window.

Failing to sign up during this time can result in gaps in your coverage and late enrollment penalties, which often leads to a lifetime premium increase. However, you may be able to avoid penalties if you have insurance through your employer at 65 and enroll in Medicare as soon as you lose this coverage.

3. Medicare is free for everyone

You won't have to pay a Part A premium if you or your spouse paid Medicare taxes for at least 10 years throughout your career. However, those who don't meet this criteria will pay a premium for this coverage. All Medicare beneficiaries have a $1,676 Part A deductible in 2025.

Medicare Part B has a monthly premium of $185 for most people, though some high earners pay up to $628.90 per month. Part B also has a deductible and copays. If you enroll in a Part D plan or Medicare Advantage plan, these will have their own costs.

4. Medicare is all you need in retirement

Original Medicare consists of hospital insurance (Part A) and medical insurance (Part B). Part A covers in-patient hospital stays, skilled nursing care, hospice care, and home healthcare. Part B covers a range of services, including outpatient care, durable medical equipment, and preventive services.

You'll need to add an optional Part D plan if you want prescription drug coverage, though. Even then, you'll have to pay for things like dental and vision care and hearing aids out of your own pocket unless you choose to purchase a Medigap or Medicare Advantage plan.

5. Medigap is the same as Medicare Advantage

Medigap policies, also known as Medicare supplement policies, are policies that are intended to provide services Original Medicare doesn't cover. You purchase one of these from a private insurer and you have separate bills, premiums, and deductibles for your Medigap and Medicare plans.

Medicare Advantage is an alternative to Original Medicare available through private insurers. A Medicare Advantage plan covers everything in Original Medicare and it may include some extras as well. If you go this route, you'll only have one premium and deductible to worry about. But you're usually restricted to using doctors in the Medicare Advantage plan's network.

6. You don't need Part D if you don't take any medications regularly

While a Medicare Part D plan might be most valuable to seniors who routinely take medications, it's still worth considering even if you don't. You never know when you might need to take medication for a short time or when you might develop a more serious illness that requires regular medication. A Part D plan can help cover some of these costs for you.

Part D plans can also cover the cost of certain preventive treatments, like vaccines, that can help you avoid diseases in the first place.

7. Once you sign up for Medicare, you're locked into a plan forever

Every year, there's an Open Enrollment Period that runs from Oct. 15 to Dec. 7. During this time, you can switch from a Medicare plan to a Medicare Advantage plan or vice versa. You can also choose a new Medigap or Part D plan. If you switch your plan during this window, your new coverage will take effect on Jan. 1 of the following year.

If you have any questions about your Medicare plan, it's best to reach out to the Center for Medicare and Medicaid Services. Or if you have a Medicare Advantage or Medigap plan, you can contact the private health insurer associated with it to learn more about coverage and costs.

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Disclaimer: For information purposes only. Past performance is not indicative of future results.
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