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9 Medicare Myths You’ll Want to Know

Medicare is a term that you likely hear often, especially if you’re eligible. But, like many insurance programs, the specifics can be fuzzy. Making matters worse, myths about Medicare begin floating around when it’s time for open enrollment. We want to help clear up the most common misconceptions about Medicare, so here are nine myths you’ll want to know.

Myth 1: You can enroll at any point during the year.

Unfortunately, you cannot enroll in Medicare at any time—unless you are eligible for special enrollment. You must enroll in Original Medicare (parts A and B) within a seven-month period that begins three months prior to your 65th birthday, your birthday month, and then three months after your birthday. If you do not enroll during this period, you must enroll during the annual open enrollment period, which begins November 11th and ends December 7th for the year 2020.

To learn more about your coverage options, please visit the official Medicare website.

Myth 2: You can only get Medicare through the government.

Contrary to popular belief, Medicare is not only available from the government. The program is managed by the government. However, there are four parts of Medicare: Part A, Part B, Part C, and Part D. For parts A and B, it’s correct that they are offered by the government only, but private companies provide parts C and D. 

Myth 3: Your Medicare plan will not cover prescriptions.

While parts A and B provide only basic coverage for prescription drugs, which is fairly limited, Part D exists to supplement your coverage. Established less than 20 years ago, Part D is available through private insurance companies as an addition to your Part C plan or can be purchased as a standalone plan. Pay close attention to ensure that the plan you choose covers the prescriptions that you need. 

Myth 4: Your Medicare plan will cover all your medical expenses.

Medicare Part A and Part B are not free services, though many people think of them this way. They will cover only a portion of your costs, and you must pay for your premiums, deductibles, coinsurance, and copayments—like you would for any other medical insurance. If the original Medicare plans (A and B) do not meet your needs, you may consider adding plans, such as parts C and D. 

Myth 5: You will be enrolled automatically.

Though many think that they will be enrolled in Medicare automatically once they are eligible, that simply isn’t true—and could be a major disappointment if you realize it once you’re outside of the open enrollment period. To enroll in Medicare, you must contact your social security office or enroll online at socialsecurity.gov

Myth 6: You are enrolled automatically when your spouse is enrolled.

You and your spouse are required to apply for Medicare individually, as you may qualify at different points in time. Medicare does not operate like workplace insurance plans where a spouse can be insured through their partner’s plan. 

Myth 7: Your Medicare covers assisted living and home care.

While Medicare covers some parts of long-term care—portions of nursing home care and physical therapy, for example—it does not cover assisted living facilities or in-home help for basic daily needs. You will want to be sure that you have an understanding of what your Medicare plan covers and how you plan to budget for care expenses as you age. 

Myth 8: If I have medical issues, I will not qualify for Medicare.

Thankfully, you cannot be rejected for Medicare parts A and B due to a pre-existing condition. Do not hesitate to apply, as there may be penalties for not enrolling at the appropriate time. If you are concerned about your Medicare coverage and whether it’s the right amount of coverage for your medical needs, it’s wise to discuss this concern with a professional

Myth 9: The cost of Medicare is the same for everyone.

What you pay for any of the four parts of Medicare will vary from person to person. Your payment can be influenced by your work history and other factors, but overall, do not be surprised if you’re paying more or less than your peers. 

Are you ready for open enrollment? 

Our advisors are here to help guide you along your Medicare enrollment journey. Contact us today to schedule a consultation.

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