I know the whole idea of a government health insurance is appealing, especially if you have given a significant part of your earnings each pay period, but what if some of the conceptions you have about the program aren't accurate?

Statistics have shown that over 60 million Americans use Medicare every day, with over 10,000 people becoming eligible for the program every day, but there are still a lot of misconceptions about how the program really works. 

Therefore, it is very important that you know Medicare details, as delay and false information can be very costly, especially for the old.  Are you eligible for the program, or do you want to help your older adult understand the health benefits and debunk the myths associated with the scheme? 


Not to worry! Here are five misconceptions and their underlying truths: 
•    MYTH 1: Medicare covers everything!
Common belief: Medicare is a health benefit offered by the government, so I do not have to pay for anything. 

Truth: That is not correct! Although it is an undeniable fact that Medicare is tax-funded and some parts of the program may be ‘free,' retirees are expected to cover certain expenses by themselves.

For instance, hospital insurance, also known as Part A, has no premium attached to it. However, Part B which covers outpatient services requires a stipulated premium amount. Part C (Medicare Advantage) and Part D (prescription drug coverage) sometimes require monthly premiums. Deductibles, coinsurance, and copayments depend on the plan you enroll on. Therefore it is essential to consult with a trusted advisor on selecting additional coverage.


•    MYTH 2: Notification before enrollment
Common belief: I will receive a notification before being enrolled.

Truth: The truth is that….it depends!
Usually, if you receive Social security benefits, you will be automatically enrolled in the program once you are 65. But if you are not receiving this, you can sign up for Medicare by reaching out to the Social Security Administration during the seven-month enrollment gap. You can equally sign up for Medicare Advantage or Supplemental plan which the original Medicare does not cover, but you will not receive notification. 
So if you are going for this, it’s important that you mark your calendar: three months before you are 65, your birth month, and three months after.


•    MYTH 3: Medicare is completely free
Common belief: Medicare is funded from my taxes, so I do not have to pay anything extra.

Truth: That’s false. While it is true that Medicare is funded from taxes, it is not a one-size-fits-all thing. Let’s take a look.
Part A: Many people do not pay monthly premiums for this plan, but there may be some costs for hospital patient coinsurance and deductibles. 
Part B: This largely depends on your income and whether you receive Social Security benefits or not. Your coinsurance and deductible will also vary. 
Part C (Medicare Advantage) and Part D (Prescription Drug Coverage): Your monthly premiums, deductibles, and copayments also vary, depending on your income range. 


•    MYTH 4: I can enroll whenever I choose to.
Common belief: I can enroll whenever I choose to, and everything remains the same. 

Truth: No unfortunately you can’t. There are some guidelines and rules that include the timeframe for enrollment. The initial enrollment period is during three months before you turn 65, during your birth month (when you turn 65), and three months after your 65th birthday. If you miss this, you could possible have to pay a penalty. 

•    MYTH 5: Medicare and Medicaid (which we call AHCCCS here in Arizona) are the same things.
Common belief: I enrolled for Medicaid (AHCCCS), so I am already on Medicare. 

Truth: No, they are two separate programs. 
Medicare is a program meant for people 65 years and above, who have paid ten years or more of social security. Medicaid is an insurance program created for low-income people irrespective of age and is operated by each U.S state. Although it is possible to be eligible for both, you have to apply for them differently.  Contact us if you need any questions about this. Phone: 480-231-6989

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