Is Your Mailbox Full? Myths of Medicare (05-11-15)

This is the Third Article in the "Milestone Series",
you can view the other articles in the series here:
Article 1 (Spring Break Traveling), Article 2 (Career Advancement), Article 4 (To Have & To Hold), and Article 5 (When I am Your Age... Really?.




You don’t need a huge birthday celebration to realize that you are turning the magical age of 65.  All you really have to do is check your mailbox...the postal mailbox.  Brochures, pamphlets, solicitations and the “Medicare and You” booklet begin showing up at your door when you are only 64.  Why?  Because there is much to learn and no one wants to be late for the party.  As one client said, they were barraged with a plethora of information they had no idea what to do with so they called us.

Unfortunately, just like those turning 50 tossed the red and white solicitations to join that organization, many people do the same with Medicare-related information.  Or they put it in the “look at later pile” that eventually gets recycled during a rush clean of the house before company arrives.  I totally understand procrastinating and the “stop the madness” mentality but this paperwork is important to your future and procrastinating can cost you dearly.

There are many myths surrounding Medicare and if you take one of them as gospel then you might find your wallet a bit lighter.  If you have no desire to peruse your “Medicare and You” booklet, then call us and we can give you the highlights.  In the meantime, let’s explore a few of the myths.



Myth #1 – Medicare is Free – Not hardly.  More than likely, you paid into the Medicare Program during your working years.  This will give you access to Medicare Part A which covers hospital services.  However, in order to receive Medicare Part B which covers medical services such as physicians and outpatient expenses then you will need to sign up and pay a monthly premium.  If you fail to apply or defer your Part B benefits then you can be subject to a lifetime penalty of 10% per year for each 12-month period that you did not apply or defer.  You must also take action to have your prescriptions covered.

Myth #2 – I automatically get Medicare – When you turn 65, you have a seven month enrollment period that begins three months prior to your birth month and ends three months after your birth month.  If you are not already receiving Social Security retirement benefits then action is required on your part.  You must apply and elect your Part B benefits or you will be subject to a lifetime penalty of 10% per year for each 12- month period in which you fail to take action.  The penalty is assessed on the Part B premium.  Also, you should elect a stand-alone Part D prescription drug plan.  There are penalties if you do not elect this plan when you are eligible.

Myth #3 – Medicare will cover all of my medical expenses – The Medicare Program covers many medical expenses however there are deductibles you are responsible for before Medicare will pay.  A supplemental policy through an insurance carrier will pick up most or all of these out-of-pocket expenses.  Also, as stated above, prescription drugs are not covered unless you obtain a stand-alone Medicare Part D prescription drug plan from an insurance carrier.  You can also elect a Medicare Advantage plan (Medicare Part C) through an insurance carrier to handle your hospital, physician and prescription drug expenses.

Myth #4 – Medicare will pay similar to how my group insurance did – Not quite.  Medicare is managed by the Centers for Medicare and Medicaid Services.  There is a specified list of benefits Medicare will pay and how they will pay them.

Myth #5 – I can keep my current doctor when I go onto the Medicare Program – Maybe and maybe not.  If you are covered by Original Medicare then you can go to any provider who “accepts” Medicare patients.  This means your provider has agreed to accept the terms of payment stipulated by Medicare.

Myth #6 – Medicare will cover my long term care facility expenses – Yes, this is true to an extent.  Medicare provides benefits for Skilled Nursing Facility Care, however there are provisions such as a hospital stay, a daily amount you will be responsible for and after 100 days...Medicare will cover nothing.  

Myth #7 – I won’t need Medicare until I retire which is after I turn 65 because I am already covered by a group health insurance plan. – Many people think this however once again there are caveats as to when Medicare will pay.  If you work for an employer with 20 or more employees, then your group insurance will generally pay first.  Your provider can then send expenses to Medicare for additional payment up to the Medicare approved amount.  If you work for an employer with less than 20 employees, then most likely Medicare is your primary payer.  This means your insurance company pays second and will deduct what Medicare would have paid – even if you didn’t sign up for Part B.



Have you had enough of myths and facts or did I lose you after Myth #1 or Myth #2?  If so, I completely understand.  And these are not the only myths surrounding Medicare. 

These are your “Golden Years” and trying to decipher your health insurance benefits isn’t the most fun way of spending your time.  But...it must be done.  We are here to help you make the process as smooth as possible.   

If you have any questions about Madicare or would like any
help with your plan, please Contact us

This is the Third Article in the "Milestone Series", you can also view
Article 1 (Spring Break Traveling) and Article 2 (Career Advancement).

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