Common Myths Surrounding Medicare
Myths are much like rumors—they often start with a kernel of truth, but over time, they become distorted. When it comes to Medicare, there are plenty of misconceptions that can confuse people. Today, we'll set the record straight and tackle some of the most common myths.
Myth: Medicare is free
Medicare is not free. If you're already on Medicare, you're probably aware of this. Every Medicare beneficiary pays for Medicare Part B. In 2025, Medicare Part B premium is $185.00/month. Some Medicare beneficiaries with limited income may qualify for Medicaid, which can help cover certain costs, including the Medicare Part B premium.
If you’ve earned 40 tax credits, then you will qualify for premium-free Medicare Part A. Most Medicare Beneficiaries qualify for Part A at no cost. However, if you have not worked 40 tax credits, then you will need to pay a monthly premium for Part A, which can range from $285 to $518, depending on the number of work credits you and your spouse have.
Learn more about qualifying for premium-free Part A.
Myth: Medicare Covers All Healthcare Expenses
While Medicare covers a significant portion of medical expenses, Medicare doesn't cover all healthcare costs. Some healthcare services that are not covered by Medicare are: Dental, Vision, or Hearing. A separate insurance policy is needed to cover these types of expenses.
Note: While original Medicare does not cover dental, vision, or hearing, some Medicare Advantage plans include these benefits.
Myth: Medicare covers all prescription drugs
Each insurance carrier has a formulary of covered medications. Some prescription drug plans may require step therapy before covering a specific medication. Step-therapy is when a carrier requires the member to try alternative medications which cost less before providing coverage for the requested medication. However, even with step therapy, not all medications are covered by Medicare.
Medicare often does not provide adequate coverage for hormonal medicines and will not provide coverage for weight loss medicine if not prescribed for diabetes.
Myth: All Medicare Advantage plans have the same network
Some people believe that if their doctor doesn’t accept a specific Medicare Advantage plan, they can’t enroll in any Medicare Advantage plan. That’s not true. Each Part C plan has its own network of providers who accept the plan. While networks are often similar within the same carrier, they can vary significantly between carriers.
For example, the network for the United Healthcare Chronic Complete (HMO) plan is similar to that of the United Healthcare MS-0001 (HMO-POS). However, the network will differ greatly when comparing the United Healthcare Chronic Complete (HMO) plan to the Humana Gold Plus (HMO) Medicare Advantage plan.
Myth: You can’t enroll in Medicare if you’re still working
You can choose to enroll in Medicare even if you plan to continue working past age 65. Depending on your premium, maximum-out-pocket, and copays, Medicare might actually be a better option than employer coverage. However, it’s important to be cautious and avoid any enrollment penalties if you decide to delay Medicare enrollment.
Myth: Medicare covers long-term care
Unfortunately, Medicare does not cover long-term or custodial care.
Did you find that you previously believed any of these myths? If so, we’d love to hear your input. Consider sharing what myths you believed when first enrolling in Medicare. Let us know if this article helped you!