Common Mistakes and Misconceptions to Avoid
Navigating Medicare is a new experience, and it’s easy to stumble into a few common pitfalls. Being aware of these ahead of time can save you from future headaches, stress, and extra costs.
Mistake 1: Missing Your Initial Enrollment Period (IEP)
This is the most common and costly mistake. Many people assume they can just sign up whenever they’re ready, but that’s not how it works. If you miss your 7-month IEP and don’t have other qualifying health coverage (like from an employer), you could face a late enrollment penalty for Part B. This isn’t a one-time fee; it’s an extra amount added to your monthly premium for as long as you have Part B.
For example, the Part B penalty is an extra 10% of the standard premium for each full 12-month period you could have had Part B but didn’t sign up. If you wait two years, your premium will be 20% higher for the rest of your life. The same applies to Part D. Don’t let this happen to you. Mark your calendar and sign up on time.
Misconception 2: Medicare Covers All Healthcare Costs
Many people are surprised to learn that Medicare does not cover everything. Original Medicare was designed to cover many hospital and medical services, but there are notable gaps. Most importantly, it generally does not cover:
Long-term care (also called custodial care), such as help with daily activities in a nursing home or assisted living facility.
Most dental care, including cleanings, fillings, or dentures.
Eye exams related to prescribing glasses.
Hearing aids and exams for fitting them.
This is why Medigap policies and Medicare Advantage plans exist—to help cover these services or the out-of-pocket costs associated with Original Medicare. It’s crucial to plan for these expenses in your retirement budget. For general support and resources for older adults, the National Council on Aging (NCOA) is an excellent organization.
Misconception 3: Medicare and Medicaid Are the Same Thing
This is a frequent point of confusion, but the two programs are very different. This is a key part of understanding the difference between Medicare and Medicaid.
Medicare is a federal health insurance program based on age (65+) or disability, regardless of your income. You earn eligibility by paying Medicare taxes during your working years.
Medicaid is a joint federal and state assistance program that provides healthcare coverage to people with very low income and limited resources, regardless of their age. Eligibility rules vary by state.
It is possible for some people to be eligible for both programs. These individuals are called “dual-eligibles” and can get help with costs that Medicare doesn’t cover. To see what government assistance programs you might qualify for, including Medicaid, you can visit Benefits.gov.
And remember, tax rules related to healthcare can be complex. For any questions about how your healthcare costs might affect your taxes, the best source is always the official one. Tax information and forms can be found at the Internal Revenue Service (IRS).
