There are plenty of myths about Medicare people believe are true because they saw it in a social media post. Or, maybe they heard more than one person say it, so it must be “common knowledge.” Below are the most common Medicare myths, along with the factual realities.
Medicare Myth #1: Coverage Is Free for Everyone Who Qualifies
What’s Really True: medicare’s Not Completely Free for Anyone
If you paid Social Security and Medicare payroll taxes for 10+ years, then you may qualify for premium-free Part A. However, you must be disabled or aged 65 and older to avoid that monthly premium charge. Part A provides you with hospital coverage, but you’ll still pay an annual deductible and coinsurance for any hospitalization stays. In addition, you’ll pay monthly premiums for Medicare Part B (medical insurance), Medicare Advantage or Medigap supplement plans. This is true regardless of whether you qualify due to your age or have disability-based coverage. See a complete breakdown of current Medicare costs here.
Medicare Myth #2: The Government Automatically Enrolls You When You Turn 65
What’s Really True: You Can Only Sign Up During Certain Medicare Enrollment Periods
If you’re about to turn 65, your Medicare enrollment period begins three months prior to your birthday. The federal government gives you seven months total to sign up for Medicare Part A and Part B without penalties. Once that initial enrollment period ends, you may pay a penalty if you sign up later.
Medicare Annual Enrollment Period Starts 10/15
$0 monthly premium Medicare Advantage plans may be available in your state.
Disabled people who qualify for Social Security Disability Insurance (SSDI) payments can get Medicare coverage after 24 months. You cannot sign up for disability-based Medicare unless you receive those benefits unless you have end-stage renal disease (ESRD). Once your third month on dialysis passes, kidney failure patients can then sign up for Medicare coverage. Finally, if you have Lou Gehrig’s disease, you can get Medicare coverage as soon as your first SSDI payment arrives. Only Lou Gehrig’s patients can skip the mandatory 24-month wait for Medicare that applies to all SSDI beneficiaries.
Medicare Myth #3: The Government Provides Free Medicare For People On Disability
What’s Really True: People On Social Security Disability Pay for Coverage
If you qualify for SSDI, then it’s true you can get Medicare coverage 24 months after your benefits begin. (The lone exceptions to this mandatory wait period are ALS and ESRD patients.) But just like people turning 65 years old, those on disability can only get premium-free Medicare Part A coverage. Once eligible, the Social Security Administration automatically deducts Part B premiums from monthly disability benefits prior to paying the beneficiary.
Medicare Myth #4: You Don’t Need to Enroll If You Already Have Health Insurance
What’s Really True: You May Pay A Penalty, Regardless
You don’t have to enroll in Medicare if your health plan comes from an employer with 20+ employees. That’s true whether you or your spouse’s employer provides this healthcare coverage. However, once you or your spouse stops working, you must enroll in Medicare within eight months. If you don’t enroll in Medicare Part A and Part B during this special enrollment period, it’ll cost you. After that period ends, you’ll pay higher premiums for every year you delay your enrollment. What’s more, those higher premium costs never go away – you’ll pay them for the rest of your life!
Medicare Myth #5: You Can’t Change Your Coverage After You Enroll
What’s Really True: You Can Switch Plans During Your Annual Medicare Open Enrollment Period
There are many supplement plans (usually referred to as “Medigap plans”) to choose from besides Part A and Part B. While those two plans comprise Original Medicare, they don’t include things like:
- Prescription drug coverage
- Medical insurance while you’re traveling abroad
- Long-term residential care (nursing home fees)
Every year, you can review your policy coverage and make changes based on your current health and lifestyle needs. However, you must make those changes during Medicare Open Enrollment, which happens every year from October 15 to December 7.