7 Common Medicare Myths That Could Cost You
Medicare is one of the most important programs for retirees, but it’s also misunderstood. Believing common myths can lead to costly mistakes, from missed deadlines to inadequate coverage.
Here are seven of the biggest Medicare myths and what you need to know instead.
1. The Government Will Automatically Enroll You
Some people are auto-enrolled in Medicare Part A and Part B if they already receive Social Security benefits at least four months before turning 65. But if you're not on Social Security at age 64 and 8 months, you must actively enroll during your initial enrollment window.
And even if you are receiving Social Security, residents of Puerto Rico are only automatically enrolled in Part A. You still need to manually sign up for Part B.
2. You Can Sign Up Anytime After 65
Your initial enrollment period runs from three months before your 65th birthday to three months after. Missing this window can lead to a gap in coverage and permanent late penalties.
There are exceptions. If you have employer-sponsored insurance at age 65, you may be able to delay enrollment without penalty. But once that coverage ends, you’ll need to enroll promptly to avoid fees.
3. Medicare Is Free for Everyone
Medicare is not free. Part A is premium-free only if you or your spouse paid Medicare taxes for at least 10 years. Otherwise, you’ll owe a monthly premium.
Part B has a standard monthly premium of $185 in 2025, though high-income earners may pay more. You’ll also face a deductible and copays. Prescription drug plans (Part D) and Medicare Advantage plans carry additional costs.
4. Original Medicare Covers Everything You Need
Original Medicare includes Part A (hospital coverage) and Part B (medical coverage), but it doesn’t cover everything. You’ll pay out of pocket for prescription drugs unless you add Part D. Services like dental, vision, and hearing aren’t covered unless you enroll in a Medicare Advantage plan or purchase supplemental coverage.
5. Medigap and Medicare Advantage Are the Same
Medigap and Medicare Advantage are very different. Medigap policies supplement Original Medicare and help cover out-of-pocket costs like copays and deductibles. You keep Original Medicare and pay a separate premium for your Medigap plan.
Medicare Advantage is a replacement for Original Medicare. These plans bundle hospital, medical, and often prescription drug coverage into one plan, typically with lower premiums but network restrictions.
6. You Don’t Need Part D if You’re Not Taking Medications
Even if you're not on regular prescriptions, a Part D plan is still worth considering. It can help cover the cost of future medications and preventive treatments like vaccines. Waiting to enroll can also result in late penalties, even if you don’t currently need the coverage.
7. You're Locked Into Your Plan Forever
Medicare plans are not permanent. You can make changes each year during the Open Enrollment Period, which runs from October 15 to December 7. During this time, you can switch between Original Medicare and Medicare Advantage, choose a new Part D plan, or update your supplemental coverage. Any changes take effect January 1.
Have questions about Medicare and retirement coverage?
Our team at Sandbox Financial can help you make confident, informed decisions. Reach out anytime or contact us today.