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When you begin your Medicare journey, you encounter a lot of information, and some of it can be pretty confusing. So it’s no surprise that there are some common misunderstandings about Medicare. Unfortunately, these misunderstandings can cost you in terms of time, money and health.
To help clear up some of the misconceptions, we spoke to Jennifer Kehm, a member experience strategist at Aetna. She’s an expert with extensive experience serving beneficiaries at the Centers for Medicare and Medicaid Services (CMS) as an account manager and state lead. “There's a lot of material out there,” says Kehm. “You need to filter through the noise to really know what's credible.”
“There's a lot of material out there. You need to filter through the noise to really know what's credible.”
We asked Jennifer to help identify some of the most common and persistent myths that exist about Medicare. Here are five of the biggest Medicare misunderstandings and what you need to know about each of them.
The first misunderstanding is the idea that Medicare is free for everyone once they turn 65. “This misunderstanding does have kernels of truth,” says Kehm. “Most people won’t have to pay a premium for Medicare Part A.” However, Medicare Part B does have a monthly premium. If you choose an Original Medicare plan, which is made up of both Medicare Part A and Part B, you will pay for your Part B premium.
If you forego Original Medicare and opt for a Medicare Advantage (MA) plan, you may have the option to choose a $0 premium MA plan. But you will still be responsible for paying your Part B monthly premiums, just as you would with Original Medicare.
For more information, visit our article Unpacking the parts of Medicare: Parts A, B, C, D and Medicare Supplement plans.
You can choose to enroll in a Medicare plan during your Initial Enrollment Period (IEP). This is the seven-month window of time encompassing your birthday month and the three months before and after it. You may face a penalty in the form of higher premiums if you don’t enroll during your IEP. And the longer you wait, the higher the potential penalties. You can also change Medicare plans during the Annual Election Period (AEP). It’s a good time to review your coverage options and choose the best plan for you.
If you’d like more information on the enrollment process for Medicare, visit our article Unpacking Medicare: What you need to know about Medicare enrollment periods.
Medicare is made up of different parts. Part A covers services for hospital stays. Part B includes coverage for doctor visits and other procedures that don’t require an overnight hospital stay. Together, Parts A and B make up Original Medicare. Part C, also called Medicare Advantage (MA), is made up of plans offered by private insurance companies. Part C usually includes a network of health care providers. Part D provides prescription drug benefits. Lastly, Medicare Supplement plans work with Original Medicare and are offered by private insurance companies. These different options for Medicare each come with different costs and coverage.
If you’re interested in seeing how you can use the different parts of Medicare to get the best coverage for you, visit our article What do the parts of Medicare cover?
A standalone Medicare Part D plan or an MA plan with Part D coverage will help you pay for your prescription medications. But “the pricing really fluctuates depending on the coverage stage you’re in,” says Kehm. Meaning, you may not always pay the same amount for your drugs. The amount you pay can also vary depending on the pharmacy you use. And it can vary between different Medicare plans.
For more information on the Medicare Part D drug payment stages, visit our article Unpacking Medicare: What do I need to know about prescription drug coverage?
Medicare and Social Security are separate government-run programs. The Social Security Act was signed by President Roosevelt in 1935. Medicare came 30 years later. It was signed into law in 1965 under President Johnson. Your eligibility for both programs is usually associated with your age and how long you or your qualifying spouse have worked. But the similarities generally end there.
To learn more about eligibility and how to sign up for Medicare, visit our article Unpacking Medicare: What you need to know about Medicare enrollment periods.
With all the information available to you, it’s more important than ever to have trusted sources to filter through the noise. "It's pretty hard to know whom to go to,” says Kehm, “and where you can find information that's credible.” That’s why arming yourself with the basic facts and a strong foundation of knowledge is so important. That information can help you take advantage of your options and choose the best plan for you. We invite you to visit our online destinations and reach out to our telesales team with any questions.
Noah Hughes is a writer, researcher, and multimedia storyteller. He loves exceptional storytelling and finds his greatest joy in bringing ideas to life for people all around the world. When not writing he spends his time traveling, working on his photography, and eating good food.
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