10 Medicare Myths You Should Know About

Source The Motley Fool

A record-breaking 4.18 million Americans are set to turn 65 this year. And even if they're not planning on retiring anytime soon, those 4.18 million must sign up for Medicare. What's particularly interesting about a health program impacting so many people is how much confusion surrounds it.

Here, we examine 10 of the most common myths associated with Medicare and separate facts from fiction.

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Older person dressed in collared blue shirt, studying options available on a pharmacy shelf.

Image source: Getty Images.

Myth #1: Medicare is free for everyone

Reality: Some parts of Medicare (Part A, hospital coverage) are free for individuals who worked and paid Medicare taxes, but most people are still required to pay premiums, deductibles, and copays. Those copays cover other parts of Medicare, like Part B (medical coverage) and Part D (prescription coverage).

Myth #2: Medicare covers everything

Reality: As mentioned above, there are different parts to Medicare, and the number of parts you carry determines how much you pay. If you want dental, vision, or hearing coverage, you must choose Medicare Advantage or a supplemental plan that includes them.

Myth #3: You're automatically enrolled when you turn 65

Reality: You're required to enroll in Medicare, usually around three months before your 65th birthday.

Myth #4: You're automatically covered by Medicare if your spouse has coverage

Reality: While this myth is an easy one to believe due to the way we often share a traditional healthcare plan with a spouse, it doesn't relate to Medicare. Your spouse's plan covers only them, and your plan will cover only you.

Myth #5: If you're on Medicare, you won't have coverage outside the U.S.

Reality: Although Original Medicare doesn't typically cover care outside the U.S., Medigap may provide extra coverage for travelers.

Myth #6: Choose your Medicare plan carefully because you're stuck with whatever you choose

Reality: If you don't like your plan, you can choose a new one during the annual enrollment period of Oct. 15 to Dec. 7.

Myth #7: Medicare will cover long-term care if you need it

Reality: While Medicare typically covers short-term care in a skilled nursing facility following a hospital stay, it doesn't cover long-term care, assisted living, or daily custodial care.

Myth #8: Doctors are required to accept Medicare

Reality: Many doctors do accept Medicare coverage, but some choose not to do so.

Myth #9: Medicare and Medicaid are the same

Reality: Although each program was initially designed to help Americans get the care they need, Medicare and Medicaid are very different. Medicare is a federal program for people 65 and older and younger people with disabilities. Medicaid is a state-administered program for low-income families and individuals.

Myth #10: There's only one way to get Medicare coverage

According to the Social Security Administration (SSA), if you opt for Original Medicare coverage (Part A and Part B), you can buy a Medicare Supplement Insurance (Medigap) from a private insurance company. Many seniors find Medigap attractive because it covers some of the costs not covered by Medicare, including copayments, deductibles, and coinsurance.

In addition, if you choose Medicare Advantage, you can buy a Medicare-approved plan from a private company that bundles Part A, Part B, and often Part D into a single plan.

While most people refer to those signing up for Medicare this year as baby boomers, they're more accurately referred to as Generation Jones. Although Generation Jones may be a subset of baby boomers, their formative experiences had little in common with their older brothers and sisters.

Now that they've slipped past middle age, Generation Jones can look to their boomer friends to learn how they handled the multitude of choices that signing up for Medicare requires. And hopefully, if they hear something about Medicare that doesn't sound "just right," they can ask a more experienced baby boomer for the real scoop.

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