Common Myths About Medicare Plans & The Truth Behind Them

February 28, 2025•4 min read

Medicare can be a confusing topic for many, especially when faced with the numerous myths surrounding it. At Bourgeois Insurance Agency, LLC, located in Thibodaux, Louisiana, we aim to debunk these myths and provide clarity to help you make informed decisions. Our team is here to guide you through your options and ensure you get the best coverage possible. If you have any questions, feel free to call us at (985) 803-8999.

Myth: You Can Enroll in Medicare Whenever You Want

One of the most common myths is that you can enroll in Medicare at any time. In reality, there are specific periods when you can enroll in Medicare. The Initial Enrollment Period is a seven-month window that begins three months before you turn 65, includes the month you turn 65, and ends three months after. Missing this window might lead to late enrollment penalties.

Initial Enrollment Period: Begins three months before you turn 65
General Enrollment Period: January 1 to March 31 each year
Special Enrollment Period: Available in certain circumstances, such as losing other health insurance

Ensure that you understand these timeframes to avoid unnecessary penalties or gaps in coverage.

Myth: Medicare Covers Everything

Another widespread myth is that Medicare covers everything. While Medicare provides substantial help, it does not cover all health-related expenses. Original Medicare, which includes Parts A and B, covers hospital and medical services but does not typically cover dental, vision, or long-term care.

For services not covered by Original Medicare, you might consider a Medicare Advantage Plan or a Medicare Supplement (Medigap) plan to help with additional costs. It's crucial to understand the coverage limits and consider additional insurance to fill any gaps.

Myth: Medicare is Free

Many believe that Medicare is free, but this is not the case. While Part A is generally premium-free for most people who have paid Medicare taxes while working, there are costs associated with other parts:

Part B Premium: A monthly premium is required for Part B, which covers medical services.
Medicare Advantage Plans: These may have their own premiums, copays, and deductibles.
Prescription Drug Plans: Part D plans have separate premiums.

Understanding these costs helps in planning your healthcare budget effectively.

Myth: You Are Automatically Enrolled in Medicare at 65

Some people on Medicare are automatically enrolled at 65, but this typically occurs if you are already receiving Social Security benefits. If not, you will need to sign up for Medicare during your Initial Enrollment Period.

Failing to enroll on time can result in penalties and delays in coverage. It's important to know your status and take the necessary steps to ensure you're covered when you need it.

Myth: You Don’t Need Medicare Part B if You Have Other Insurance

While having other insurance might make Medicare Part B seem unnecessary, it is often beneficial. Part B covers essential services that other insurances might not, such as outpatient care, preventive services, and some home health care. It's important to evaluate your existing insurance plan and determine if Part B could complement your coverage.

Myth: Medicare Advantage Plans are the Same as Original Medicare

There is a misconception that Medicare Advantage Plans (Part C) are the same as Original Medicare. While they provide the same basic coverage as Parts A and B, they often offer additional benefits like dental, vision, and even fitness programs. However, these plans are offered by private companies and may have different rules, costs, and coverage options.

It's crucial to compare advantage plans and understand their benefits and limitations compared to traditional Medicare.

Myth: You Can Enroll in a Medicare Advantage Plan Anytime

Enrollment in a Medicare Advantage Plan is limited to certain periods, similar to Original Medicare:

Initial Enrollment Period: When you first sign up for Medicare
Annual Enrollment Period: October 15 to December 7 each year
Medicare Advantage Open Enrollment: January 1 to March 31

Missing these windows can limit your options and delay your benefits.

Myth: Medicaid and Medicare are the Same

Though both are government programs, Medicaid and Medicare serve different purposes. Medicare is primarily for individuals 65 and older or those with certain disabilities, while Medicaid is for low-income individuals and families. Some may qualify for both, but it's important to understand how each works and what they cover.

Myth: Spouse's Work Record Doesn't Affect Your Medicare

Your spouse's work record can play a role in determining your eligibility and costs for Medicare. If you didn't work the required 10 years, your spouse's work history might help you qualify for premium-free Part A based on their employment record.

Understanding these nuances can help you better plan for your healthcare needs and costs.