Medicare is a vital healthcare program for millions of Americans aged 65 and older, as well as younger individuals with certain disabilities. However, there are several myths and misconceptions surrounding Medicare that can cause confusion. Here are some common myths debunked to help you better understand this essential healthcare coverage.
Medicare Covers All Healthcare Costs
Medicare covers many healthcare services, but it doesn’t cover everything. Part A (hospital insurance) generally covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care. Part B (medical insurance) covers certain doctors’ services, outpatient care, medical supplies, and preventive services. However, Medicare doesn’t cover services such as long-term care, most dental care, eye exams related to prescribing glasses, dentures, cosmetic surgery, acupuncture, hearing aids, and routine foot care.
Medicare Is Free
While most people do not pay a premium for Medicare Part A if they or their spouse paid Medicare taxes while working, there are costs associated with other parts of Medicare. Medicare Part B and Part D (prescription drug coverage) require monthly premiums. Additionally, there are deductibles, copayments, and coinsurance amounts that beneficiaries are responsible for paying.
Medicare Covers Nursing Home Care
Medicare provides limited coverage for nursing home care under specific circumstances, such as for a short-term stay following a hospitalization. It does not cover long-term care services for ongoing assistance with activities of daily living, such as bathing, dressing, and eating. Long-term care services may be covered by Medicaid for those who qualify or through private long-term care insurance.
Medicare Coverage Automatically Starts When You Turn 65
Medicare eligibility begins at age 65 for most individuals, but you must actively enroll in Medicare during your Initial Enrollment Period (IEP), which starts three months before your 65th birthday month and ends three months after. Failing to enroll during your IEP may result in penalties and delayed coverage.
Medicare Advantage Plans Are the Same as Original Medicare
Medicare Advantage Plans (Part C) are offered by private insurance companies approved by Medicare. These plans provide the same coverage as Original Medicare (Part A and Part B) but may include additional benefits like vision, dental, and prescription drug coverage. Medicare Advantage Plans may have different rules, costs, and provider networks than Original Medicare.
You Can’t Change Your Medicare Coverage
Medicare beneficiaries have opportunities to change their coverage during specific enrollment periods. You can switch between Original Medicare and Medicare Advantage Plans, change Medicare Advantage Plans, join or switch Medicare Prescription Drug Plans, and make other coverage changes during these designated periods.