Can You Tell What Is Fact Or Fiction About Medicare?

1. Medicare doesn't cover everything.

Fact

Fiction

Fact. Even if you are covered by Medicare Parts A, B, and D, plus Medigap, for example, you will still incur out-of-pocket costs when you receive a service or treatment that is not covered by the plan. Plus, Medicare doesn’t cover every health-related treatment or prescription medication.

Explanation

Fact. Even if you are covered by Medicare Parts A, B, and D, plus Medigap, for example, you will still incur out-of-pocket costs when you receive a service or treatment that is not covered by the plan. Plus, Medicare doesn’t cover every health-related treatment or prescription medication.

2. Medicare pays providers the same amount other private insurance carriers pay for services.

Fact

Fiction

Fiction. In most cases, Medicare pays providers far less for services than private insurance companies pay. Unfortunately, this has caused some physicians to limit the number of Medicare patients they will see per week

Explanation

Fiction. In most cases, Medicare pays providers far less for services than private insurance companies pay. Unfortunately, this has caused some physicians to limit the number of Medicare patients they will see per week

3. Medicare is free health insurance for people 65 or older.

Fact

Fiction

Fiction. Just like when you were working and your share of health insurance costs was being deducted from your paycheck, you will pay monthly premiums for parts of your Medicare coverage. If you or your spouse worked for 10 or more years, paying Medicare taxes, Part A is free. But Part B costs nearly $100 a month and will likely increase a bit over time. Additional plans, for example, Part D drug coverage, and the MA-PD plans all carry premiums that vary considerably.

Explanation

Fiction. Just like when you were working and your share of health insurance costs was being deducted from your paycheck, you will pay monthly premiums for parts of your Medicare coverage. If you or your spouse worked for 10 or more years, paying Medicare taxes, Part A is free. But Part B costs nearly $100 a month and will likely increase a bit over time. Additional plans, for example, Part D drug coverage, and the MA-PD plans all carry premiums that vary considerably.

4. Those on Medicare are receiving only benefits they paid into while they were working.

Fact

Fiction

Fiction. The Medicare system is a “real time” system. Remember the famous “lock box” analogy a former politician referred to a few years ago? Working Americans’ Medicare deductions are not saved in a vault somewhere for them to tap into when they turn 65. Instead, they receive their benefits from taxes paid by workers now premiums they pay for coverage, and other tax sources.

Explanation

Fiction. The Medicare system is a “real time” system. Remember the famous “lock box” analogy a former politician referred to a few years ago? Working Americans’ Medicare deductions are not saved in a vault somewhere for them to tap into when they turn 65. Instead, they receive their benefits from taxes paid by workers now premiums they pay for coverage, and other tax sources.

5. Medicare Advantage is a supplement to Medicare.

Fact

Fiction

Fiction. Medigap is a supplement to Medicare, not Medicare Advantage. Medicare Advantage is sometimes called Medicare C and is really a replacement for Original Medicare. Both Original Medicare and Medicare Advantage plans carry deductibles, copayments, and coinsurance—expenses beneficiaries must pay out-of-pocket.

Explanation

Fiction. Medigap is a supplement to Medicare, not Medicare Advantage. Medicare Advantage is sometimes called Medicare C and is really a replacement for Original Medicare. Both Original Medicare and Medicare Advantage plans carry deductibles, copayments, and coinsurance—expenses beneficiaries must pay out-of-pocket.