Debunking Medicare Myths

Green Settlements Staff

Table of Contents:

  1. Myth: Medicare Is Only for Seniors
  2. Myth: Medicare Is Free
  3. Myth: Medicare Costs the Same for Everybody
  4. Myth: Medicare Covers Everything
  5. Myth: Medicare Decisions are Final

Whether they’re well into their retirement or decades away, nearly everyone in America has heard of Medicare. Introduced in 1965, the social healthcare system is never far from the public’s mind or the political conversation. More than 60 million Americans are enrolled in Medicare and more than half of registered voters consider healthcare a primary concern heading into the 2020 election.

Just because it’s well known doesn’t mean Medicare is well understood. Even Americans who are approaching eligibility don’t always know exactly what they’re in store for.

Here are the facts behind a few popular Medicare myths.

Myth: Medicare Is Only for Seniors

When it was first introduced, Medicare was only available to Americans aged 65 or older. In 1972, President Nixon broadened Medicare’s scope to cover individuals suffering from long-term disabilities and end-stage renal disease. Today, it also covers Americans with amyotrophic lateral sclerosis (Lou Gehrig’s disease).

Myth: Medicare Is Free

While it’s intended to help seniors and disabled Americans save on their healthcare needs, Medicare is far from free. In a sense, most working Americans pay for Medicare every time they get a paycheck. Both Social Security and Medicare are funded in part by taxes introduced under the Federal Insurance Contributions Act.

Making these payments for ten or more years entitles beneficiaires to premium-free Medicare Part A coverage. That’s just about the only cost that every Medicare beneficiary can avoid. For Part A coverage alone, beneficiaries face deductibles of $1,408/benefit period and daily coinsurance charges of up to $704 during long hospital stays.

Myth: Medicare Costs the Same for Everybody

Everybody’s healthcare needs are different and, as a result, Medicare costs can vary considerably from person to person. Many costs are unpredictable, but certain fixed expenses are based on the beneficiary’s annual salary. Medicare Part B’s premium, for example, increases by several hundred dollars for high-income beneficiaries.

Since Medicare Advantage, Part D, and Supplement plans are all provided by private insurers, their costs are variable, too. The government offers a Plan Finder Tool for Americans hoping to assess their options and get a sense of what they might pay each year.

Myth: Medicare Covers Everything

Medicare Part A and Part B cover a variety of necessary healthcare services, but they leave a number of gaps. Original Medicare does not cover any of the following:

  • Prescription drugs
  • Long-term and custodial healthcare
  • Routine dental exams and dentures
  • Routine eye exams and glasses
  • Routine hearing exams and hearing aids
  • Foot care and orthopedic shoes

Millions of beneficiaries choose to fill these gaps with supplemental private insurance. These plans may include a combination of Medicare Advantage, Medicare Part D, Medicare Supplement, and employer-sponsored plans.

Myth: Medicare Decisions are Final

In most cases, choosing Medicare coverage doesn’t mean sticking with the same plan for the rest of your life. Thousands of beneficiaries update their plans each year during one of the following enrollment periods:

  • A general Annual Enrollment Period is open from October 15th to December 7th each year.
  • Medicare Advantage beneficiaries have access to an exclusive enrollment period from January 1st to March 31st.
  • Depending on their home state, Medicare Supplement beneficiaries may have access to additional, exclusive enrollment periods.

Are you prepared for upcoming enrollment periods?

bbb seal