4 Myths About Medicare, Answered

Navigating Medicare can feel like wandering through a maze, especially with frequent changes in rules and coverage. Because of this, it can be hard to separate myth from truth. Your friends’ experiences with Medicare, even just a year or two ago, may not be the same as Medicare rules today or when you enroll. To add to the confusion, the internet is flooded with articles that often contradict one another. So what exactly is the truth?

As Medicare professionals with over 50 years of experience, we're here to clear up four common Medicare myths so you can easily decipher fact from fiction and be informed when it comes to making your Medicare decisions.

Myth #1: Original Medicare will cover all my medical expenses

Truth: Original Medicare is not a comprehensive coverage plan for all medical needs.

Original Medicare does not cover a variety of healthcare expenses, including dental, vision, hearing and prescription drug coverage. Additionally, Medicare does not have a maximum out-of-pocket on medical care that is covered, meaning there is no limit on how much you could end up paying on your medical expenses each year.

The best way to ensure the coverage you want is to look at all your options – including a Medicare Supplement or Medicare Advantage Plan. These are alternatives or additions to Original Medicare that may offer more coverage and limit your cost-sharing responsibilities.

Learn more about Medicare coverage.

Myth #2: Medicare is free

Truth: Medicare is a federal government-sponsored health insurance program, but it is not free.

Costs associated with Original Medicare premiums will depend on how long you’ve worked in the United States and can vary depending on your previous income. In general, you can also expect to pay a portion of the costs when you receive health care. Obtaining additional coverage, such as a Medicare Supplement or Medicare Advantage Plan can help decrease your portion of the cost-sharing.

Learn more about Medicare costs.

Myth #3: If I have a pre-existing condition, I can’t use Medicare

Truth: You cannot be rejected for Original Medicare based on your health or health history.

In the past, there were some restrictions when enrolling in Medicare Advantage plans (MA/MAPD) outside of your initial guaranteed issue period, particularly for individuals with End-Stage Renal Disease (ESRD). However, those restrictions have since been lifted.

Supplements, however, may require medical underwriting to join if you do not apply within your Guaranteed Issue Period (the first 6 months after starting Medicare Part B). If you were to apply for a Medicare Supplement policy outside of this window, your pre-existing conditions may result in a denial of your application, so it is important to review your coverage options at a time that you do not have to worry about eligibility. We at Twin City Underwriters are here to guide you through these steps to ensure that you make a sound and informed decision on your Medicare based on your specific needs.

Myth #4: I’m automatically enrolled when I turn 65

Truth: While you are eligible for Medicare, most individuals need to take a few steps to ensure you receive the coverage you want.

Those deducting from Social Security prior to their 65th birthday will, however, be automatically enrolled into Medicare Parts A and B. It is important for you to stay on top of your healthcare needs and to begin exploring Medicare options before you become eligible for Medicare. This can help avoid confusion on what steps must be taken, whether you will need to apply for Medicare Parts A and B or if you will be automatically enrolled, as well as what coverage options you will have when you transition to Medicare.

Our team of Medicare advisors at Twin City Underwriters recommends that you begin the process of reviewing your Medicare options at least 6 months before you turn 65. This will give you plenty of time to investigate and weigh your options. However, you don’t have to be 64.5 to start looking into your options – you can set up an appointment at any time with our insurance brokers. In fact, we've had individuals come to us several years before their Medicare eligibility so they can best prepare for their retirement years.

If you are going to continue working past 65 and you have creditable coverage (check with your HR department) you do not have to sign up for Medicare. You will want to apply for Medicare about 60-90 days before retirement. When questions arise on these procedures our customer service team is available to offer clarification. You may want to meet with a professional to discuss whether keeping your employer insurance or moving to Medicare is your best option.

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Get Medicare Guidance You Can Count On

These Medicare myths are common, but now that you know the truth, you can feel more confident in your own Medicare selection. But there's a lot more to Medicare to understand, like when does it make sense for you to start, what type of Medicare coverage is ideal for you and your unique health care needs? You don't have to figure it all out on your own; at Twin City Underwriters, we've been helping individuals make insurance decisions for over 50 years. We know making Medicare choices can be overwhelming, our team of experienced Medicare brokers is equipped to provide Medicare education services at no cost so you can get reliable information, trusted guidance and ongoing support.

Contact us today to set up an appointment to learn about your Medicare options.

Choosing a Medicare plan can be difficult. Twin City Underwriters helps Medicare recipients in Minnesota, Wisconsin, North Dakota, South Dakota, Iowa and Florida find the Medicare plan that meets their unique needs. Schedule a one-on-one meeting with one of our Medicare insurance brokers to get your questions answered!

Do you need help with Medicare, insurance and health plans? Explore your options with Allina Health Aetna, BlueCross BlueShield of Minnesota, Medica, HealthPartners, United HealthCare and more. We work with you to find the best plan for your needs and budget. Contact us today to get started.