8 Common Medicare Myths

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You’re eligible to receive health insurance through Medicare when you turn 65. As you approach this birthday, you’ll want to make sure you have your Medicare facts straight – because what you don’t know can cost you.


The myths explained below will help you avoid missed enrollment deadlines, inadequate coverage, and costly penalties.


Myth #1: Medicare covers all your medical expenses


Not true.


If you’re new to Medicare, you may be surprised to learn that Original Medicare (Part A and Part B) is not a free service. Original Medicare covers only a portion of your medical costs. You’re responsible for paying:

  • Premiums
  • Deductibles
  • Coinsurance
  • Copayments


With Original Medicare in 2024, for example, one would typically pay:

  • 20% of the total cost to see a doctor, after the annual medical deductible of $226
  • $1,600 deductible for hospital stays per benefit period


Additionally, Original Medicare:

  • Does not limit the amount you pay for out-of-pocket costs in a year
  • Does not offer coverage for annual hearing or eye exams
  • Does not offer coverage for Part D prescription drugs
  • Does not offer emergency care outside of the U.S.


Many people find that Original Medicare by itself doesn’t offer enough coverage and choose to enroll in a Medicare Advantage plan (Part C) that includes prescription drug coverage (Part D) – see Myth #2 for details. 


Learn more about Medicare


Myth #2: Medicare plans are only available through the federal government


Not true.


Medicare is basic health insurance available to people 65 and older, as well as people under 65 with qualifying disabilities. Medicare is a government program that consists of four parts. But only two parts are provided by the government:

  • Part A – Coverage for hospital visits
  • Part B – Coverage for medical services


Together, these two parts (Part A and Part B) make up Original Medicare.
Private insurance companies like Tufts Health Plan provide the remaining two parts, which can be added to Original Medicare to increase your coverage:

  • Part C – Also known as Medicare Advantage plans, which provide coverage for services Medicare does not cover, as well as the option to include Part D coverage
  • Part D – Coverage for prescription drugs


Learn more about how the parts of Medicare work together


Myth #3: You are automatically enrolled in Medicare


Not true.


You do not automatically receive Original Medicare (Part A and B) when you become eligible. You must enroll through the Social Security office. You can complete your enrollment online at socialsecurity.gov, by calling Social Security at 1-800-772-1213, or by visiting your local Social Security office in person.


Learn more about enrolling in Medicare 


Myth #4:  You can apply for Medicare at any time


Not true.


Most people become eligible for Medicare when they turn 65, but there is a window of time to sign up — and a penalty (in the form of increased premiums) for signing up outside of it.

  • Retiring at 65 – If you are planning to retire at age 65, you can sign up during your Initial Enrollment Period, which runs for 7 months: the 3 months before the month of your 65th birthday, the month of your birthday, and the 3 months after your 65th birthday.
  • Working past 65  – If you continue to work and receive health care coverage through your employer (or if you receive health care coverage through your spouse’s employer), you can wait to sign up for Original Medicare until you retire or your employer coverage expires. You’re eligible for a Special Enrollment Period, which is an 8-month period to sign up for Original Medicare.

Learn more about when to enroll in Medicare


Myth #5: Medicare will notify me when it’s time to enroll


Not true.


Medicare doesn’t notify you. Unless you’re already receiving Social Security by the age of 65, you’ll need to remember to sign up on your own during your enrollment period (see Myth #4 for the timeframe).  


Learn more about enrolling in Medicare


Myth #6: If your spouse is enrolled in Medicare, you’re automatically enrolled too


Not true.


Unlike health insurance provided by an employer, Medicare does not allow you to receive coverage through a spouse. To receive Medicare coverage, you have to apply for it yourself. 


Learn more about enrolling in Medicare


Myth #7:  I can’t sign up for Medicare because of poor health


Not true.


While there are penalties for not signing up at the right time, Medicare cannot reject you because you’re sick or have a pre-existing condition.


You are eligible to receive Medicare when you turn 65 or retire. Just make sure to enroll yourself — it doesn’t happen automatically. (See Myth #3 and #4.)


Learn more about Medicare eligibility


Myth #8: Medicare Advantage plans and Medicare Supplement plans are the same thing


Not true.


In addition to signing up for Original Medicare (Part A and Part B), many people decide to sign up for a Medicare Advantage (Part C) plan or a Medicare Supplement plan. These are two different types of plans.

  • Medicare Advantage (Part C) plans – Covers additional benefits not included with Original Medicare. Some Medicare Advantage plans include prescription drug (Part D) coverage. Tufts Health Plan offers both HMO and PPO Medicare Advantage plans, so you can choose the option that is right for you. 
  • Medicare Supplement plan – Fills coverage gaps in Original Medicare. Generally, these plans have higher monthly premiums than an HMO Medicare Advantage plan, but you can see any doctor who accepts Medicare. Prescription drug (Part D) coverage is not included and would need to be purchased separately.


Learn more about the differences between these plans


Don’t miss another Medicare deadline
Our Medicare Experts are local and ready to help. We’ll help find the right plan for you and ensure you understand your enrollment deadline. Call 1-844-455-3303 (TTY: 711) to chat with us, or click the button below for other simple ways to enroll
Ways to Enroll