Correcting Medicare MisconcaptionsAs I meet with people about their Medicare needs, or as I answer questions in various seminars, there are several misconceptions that I encounter. At first, I thought that maybe a handful of people thought these things, but it turns out that a lot of our seniors have been misled, misinformed, or mistaken. I hope to dispell misconceptions so that you will be more prepared in the Medicare market. Before you begin, be sure to like us on Facebook. If you find this valuable, share with your favorite social media.

1. I can only enroll in Medicare during annual open enrollment.

Every year, starting around September, you start seeing advertisements on television about Medicare open enrollment. Those of us who have worked a lot of our lives are used to open enrollment. So, naturally, we assume that the same type of open enrollment happens for Medicare as well. To quote the character Albert Nimzicki in the movie Independence Day, “That is not….entirely accurate.”

Medicare itself has one open enrollment period for you, individually, based on your 65th birthday (if you are getting that version of Medicare). Most everyone knows this. However, you do NOT have to enroll every year. There are parts of Medicare that you do have to treat annually, but that ONLY applies to Part C and Part D once you’re enrolled. Part C is Medicare Advantage. If you are enrolled in Part C, you can go back to Original Medicare only during open enrollment (October 15th – December 7) to be effective January 1st of the following year. If you are in Part D, I highly recommend revisiting that each year at this time.

If you are on Original Medicare or Medicare and a supplement, this open enrollment does not apply to you.

2. Medicare starts on my 65th birthday

Your personal Medicare starts on the 1st of the month that you turn  65. If you were born on the 1st of the month, your Medicare starts the first of the previous month. This also corresponds to the supplement start date (if you get them at the same time).

For example, if you were born on December 8th, your Medicare would be effective December 1st. If, however, you were born on December 1st, your effective date would be November 1st.

3. I HAVE to have a supplement

While I believe that supplements are great complements to Original Medicare, you are not required to have a supplement. I’ve had people call me desperately to get enrolled into a supplement by a certain date or be penalized. You are only penalized if you are not enrolled into different parts of Medicare when you’re eligible…and only if you don’t have creditable coverage at the time. Having a supplement is smart, and additional, but it is not required.

4. I have to enroll in Medicare even if I’m working

In fact, you do not have to enroll if you are able to keep your work benefits. I think it is smart to look at coverages side by side if you have the option. For some, the work benefits are better for now. In a couple of years, though, this may or may not be the case with the “Cadillac Tax.” But, if you have that flexibility available to you, be sure to weigh your options. Going onto Medicare may save you money if you do it right.

5. All supplements are the same

Medicare QuestionsI’ve seen site after site or video after video with someone quoting “All supplements are standardized and the same. The only thing that separates them are the price and the reputation of the company.” The problem with this is that it is true…but only half true. If you have had a supplement agent visit you, I hope they left a “Choosing a Medigap Policy” book with you. If they didn’t, I’ll be glad to bring you one (in Indiana) and show you what the government says about that statement. On one page, where the Center for Medicare and Medicaid Services (CMS) outlines what questions you should ask supplement companies, one of the questions is, “Do you offer any discounts or additional benefits?”

If CMS says to ask that question, you can guarantee that not all supplements are the same. All plan As or Plan Fs cover the same things on a table, but that doesn’t mean that that’s all there is. One company offers an early enrollment discount that discounts as much as 46% for enrolling early. Another offers coverage for all preventative services, even if Medicare itself doesn’t cover them. Another offers a money-saving F plan that is patented, no one else can have it. One offers vision coverage (or at least they did), and others offer high deductible options for different plans.

There are also things that affect the price. In fact, the government outlines three different ways to structure price increases. You should read here for more details. There will be a separate post just on this topic alone later on.

6. If Medicare covers it once, they’ll cover it every time

While this is true for a lot of things, there are some things that are on a schedule with Medicare. One example of this is preventative care. An example I use in my seminars is colonoscopies. When I ask the attendees how often they should have one done, their answers are anywhere from every 2 years (because of family history) to every 6 years. Medicare has a schedule of every TEN (10) years for that procedure. That means that unless there is an exception, the first procedure would be covered, but the second (unless it’s 10 years from the first one) will actually NOT be covered. This is, of course, unless you have a supplement with that preventative rider that I mentioned above.

7. If I don’t like this supplement, I can change in a few years.

This is true. But, you have to medically qualify. Going into your personal open enrollment time (there are others, email me at for details) you have the most powerful decision-making power you will ever have. You can enroll into any plan of any company that you want to–all without answering medical questions. However, outside of your personal enrollment period, you then have to answer medical questions. This means that you can get the best plan of an attained-age-rated company (this post explains it) when you’re at the best or worst of your health. When that attained-age-rated plan then does get too expensive, it is difficult to change companies if you are now unhealthy even 6 months later. Your best bet is to find a company that has your long-term outlook in mind. Would you rather save money now or save money for the rest of your life?



What are some things that you thought were true about Medicare that you are finding out isn’t entirely accurate? What have you learned by being on Medicare or working with a loved one who is enrolled?



RaphaelAbout MedicareMedicare SupplementsAs I meet with people about their Medicare needs, or as I answer questions in various seminars, there are several misconceptions that I encounter. At first, I thought that maybe a handful of people thought these things, but it turns out that a lot of our seniors have been...Making Senior Health Simple