People don’t focus on things that are not relevant to them at the moment. One of the examples can be Medicare health insurance. They don’t know how it works, what you need to do to be enrolled, or in some cases, they don’t even know the difference in the inpatient and outpatient care definition, which is essential when it comes to this program.
Because of lack of knowledge, a lot of myths have been created, and they sustained up till this day. So to clear up the confusion that surrounds Medicare, here are the most common myths debunked and what is the truth.
What is Medicare?
Before going into details, you need to know what Medicare actually is. In a nutshell, Medicare is a U. S. federal government health insurance program that was first created in 1965 and got expanded seven years later. It provides health services for people who are over 65 or have specific disabilities. The institution that is responsible for running the program is called CMS, or if you prefer Centers for Medicare and Medicaid Services. At the moment, around 60 million people are covered by Medicare.
Myth 1 – Medicare Coverage Is Free Of Charge
Fact: Medicare consists of a few different parts. Part A covers hospital care, Part B covers diagnostics and doctor visits, while Part D covers prescription drugs. Even though Part A is free for most enrollees, part B and D charge a premium.
The average amount that you need to pay for Part B premium is $135.50. When it comes to Part D, there is no standard premium as the costs will depend on the plan you choose. In both cases, depending on your income, you might have to pay more. Furthermore, you are also responsible for any premiums, deductibles and copayments that come with your choice of plan.
Myth 2 – Medicare Covers Everything
Fact: Even though Medicare health insurance covers a lot of health services, it does not cover everything. Things like dental care, vision services and hearing aids are not covered by it. Also, in most cases, prescription drug coverage is available to those who choose either Part D or Medicare Advantage plan. An exception are drugs that you receive during an inpatient hospital stay. In 2012 Medicare started to cover several preventing services such as screening and counselling for alcohol abuse, obesity and depression.
Another thing that Medicare will not cover is long-term care, like nursing homes or assisted living facilities. You will need to pay for those by yourself.
Myth 3 – Medicare Is Only For People Over 65
Fact: Indeed, Medicare is mostly directed towards older people, but if you meet specific criteria, you will be able to be put under it much earlier. If you are under 65 and you’re suffering from a disability or ESRD ( end-stage renal disease), you can be eligible for the program.
If you’ve been collecting disability benefits from the Railroad Retirement Board or Social Security Administration for the last 24 months, you are automatically enrolled into Medicare. If you have ALS, you are also automatically enrolled, but you don’t have to wait two years as it happens the moment your disability benefits start. In the case of ESRD, you are eligible to sign up, however, it doesn’t happen automatically.
Myth 4 – You Can Sign Up For Medicare Anytime
Fact: There are specific time windows during which you can sign up for different parts of Medicare. Aside from those periods, you generally can’t enrol into the program, or switch the Medicare plans. However, just as it was mentioned before – if you meet specific criteria, you will be automatically enrolled in it. Turning 65 is not one of those criteria, so you need to sign up by yourself.
Most people enrol during IEP, or Initial Enrollment Period, as it is the time when they become eligible for it. IEP spans seven months – 3 months before your 65th birthday, your birthday month, and three months after that. There are also specific periods during which you can change your plan. They are called Special Election Period (SEP), and they are different for different kinds of Medicare plans.
Myth 5 – Seniors Living Longer Will Bankrupt Medicare
Fact: The cost of caring for the elderly has been a significant concern for a few years now. However, as recent studies have shown, the end-of-life care costs have actually been dropping for the past decade. The most significant expenses that older people might encounter are those connected with long-term care, such as a nursing home, at-home care or assisted living facility care. And those are not covered by Medicare. Another myth that is connected to it and can be debunked is that the older people get, the more they become ill.
Just like with everything, Medicare also has a lot of myths surrounding it. Those listed above are only a few of the hundreds that circulate between people. People must discover the truth as sometimes, not knowing might lead to additional costs that you need to cover. And nobody likes having to pay for something they had no clue about.