Myth #1: Medicare Is Completely Free
Reality: Part A is usually premium-free, but Part B costs $185/month in 2026. Add Part D, Medigap or MA premiums, and deductibles — most people pay $200–$500+/month total for Medicare coverage.
Myth #2: I'm Automatically Enrolled When I Turn 65
Reality: Only if you’re already receiving Social Security benefits. If you’re not, you must actively sign up during your Initial Enrollment Period or face late penalties.
Myth #3: I Can Enroll in Medicare Anytime
Reality: Medicare has specific enrollment windows. Miss them and you could face permanent premium penalties and gaps in coverage. The General Enrollment Period (Jan 1 – Mar 31) exists but comes with a Part B penalty of 10% for every 12 months you were eligible but didn’t enroll.
Myth #4: Medicare Covers Everything
Reality: Original Medicare does NOT cover:
- ❌ Most dental, vision, and hearing care
- ❌ Long-term care (nursing homes for custodial care)
- ❌ Routine foot care
- ❌ Cosmetic surgery
- ❌ Healthcare outside the U.S. (with limited exceptions)
That’s why most people add supplemental coverage through Medigap or Medicare Advantage.
Myth #5: All Medicare Advantage Plans Are the Same
Reality: MA plans vary enormously by carrier, county, and year. Networks, copays, extra benefits, drug formularies, and out-of-pocket maximums are all different. Choosing the wrong plan can cost you thousands.
Myth #6: I Can Switch to Medigap Anytime
Reality: In most states (including North Carolina), your guaranteed-issue window for Medigap is 6 months starting at age 65 + Part B enrollment. After that, insurers can deny you or charge more based on health. This is one of the most expensive mistakes in Medicare.
Myth #7: My Employer Insurance Is Always Better Than Medicare
Reality: It depends on your employer size. If your employer has fewer than 20 employees, Medicare is primary and you must enroll at 65. If 20+ employees, your employer plan is primary and you can delay — but you should still take Part A.
Myth #8: Medicare Part D Isn't Worth It If I Don't Take Medications
Reality: If you skip Part D and don’t have creditable drug coverage, you’ll pay a permanent late enrollment penalty of 1% of the national base premium for every month you were eligible but didn’t enroll. That penalty never goes away.
Myth #9: An Insurance Agent Costs Extra
Reality: Licensed insurance agents who help with Medicare are paid by the insurance carriers — never by you. Working with an agent costs you nothing, and you get the same prices as going direct. What you gain is expert guidance, plan comparison, and ongoing support.
Myth #10: I Only Need to Choose a Plan Once
Reality: Plans change every year. Premiums increase, formularies shift, provider networks update, and new plans become available. The plan that was perfect last year might cost you hundreds more this year. You should review your coverage every AEP (Oct 15 – Dec 7).
Have Medicare Questions? Get Free Expert Answers.
No myths, no sales pitch — just clear guidance from a licensed independent agent.
Senior Benefits Hub is a service of Triangle Life & Health®