Medicare Myths Busted: 15 Things People Get Wrong

Medicare is one of the most important programs in American life -- and also one of the most misunderstood. After years of helping seniors navigate their coverage, we've heard just about every misconception in the book. Some are harmless. Others can cost you real money or leave you without coverage when you need it most.

Let's set the record straight on 15 myths that trip people up again and again.

Myth #1: "Medicare is completely free."

The truth: Medicare Part A (hospital insurance) is premium-free for most people -- if you or your spouse paid Medicare taxes for at least 10 years (40 quarters). But Part B (medical insurance) has a monthly premium of $185 or more in 2026, depending on your income. Part D (prescription drugs) has its own premium too. And then there are deductibles, copays, and coinsurance on top of that.

Medicare is a great deal. But "free" it is not.

Myth #2: "Medicare covers everything."

The truth: Original Medicare (Parts A and B) does not cover dental care, routine vision exams, hearing aids, long-term nursing home care, or most care outside the United States. These are significant gaps that many people don't discover until they need the services.

That's why many seniors add a Medicare Advantage plan, Medigap policy, or standalone dental/vision plan to fill in the holes.

Myth #3: "I'll be automatically enrolled in Medicare when I turn 65."

The truth: You're only automatically enrolled if you're already receiving Social Security benefits when you turn 65. If you haven't filed for Social Security yet -- because you're still working or chose to delay benefits -- you need to actively sign up during your Initial Enrollment Period (the 7-month window around your 65th birthday).

Miss that window and you could face late enrollment penalties that last the rest of your life.

Myth #4: "Medicare Advantage replaces Medicare."

The truth: Medicare Advantage (Part C) is not a replacement for Medicare. It's an alternative way to receive your Part A and Part B benefits through a private insurance company. You're still in the Medicare program. The MA plan simply delivers your benefits through its own network of doctors and hospitals, often with added perks like dental, vision, and gym memberships.

If you leave your MA plan, you go back to Original Medicare. You never actually lose Medicare.

Myth #5: "I can't change my Medicare plan once I pick one."

The truth: Medicare gives you multiple opportunities to change plans. The biggest one is the Annual Enrollment Period (AEP), which runs from October 15 to December 7 every year. During AEP, you can switch between Original Medicare and Medicare Advantage, change MA plans, or add/drop Part D coverage.

There's also a Medicare Advantage Open Enrollment Period from January 1 to March 31, and Special Enrollment Periods triggered by qualifying life events like moving or losing other coverage.

Myth #6: "Medicare covers me when I travel abroad."

The truth: Original Medicare generally does not cover health care outside the United States. If you need emergency surgery in London or break a bone in Belize, you're on your own -- unless you have a Medigap plan with foreign travel emergency coverage (most Medigap plans include this) or separate travel health insurance.

Myth #7: "All Medicare plans are the same."

The truth: Medicare Advantage plans vary enormously by insurer, region, and year. One plan might include dental, vision, hearing, gym membership, grocery allowances, and $0 premiums. Another might have narrow networks, high specialist copays, and limited extras. Comparing plans side by side is essential -- what works for your neighbor may not work for you.

Myth #8: "My spouse is covered under my Medicare."

The truth: Medicare is individual coverage. Unlike employer health insurance, there's no "family plan." Each person must enroll in their own Medicare coverage when they become eligible. Your spouse needs their own Part A, Part B, and any supplemental plans.

Myth #9: "Medicare covers long-term nursing home care."

The truth: This is one of the most expensive misconceptions out there. Medicare covers up to 100 days of skilled nursing facility care after a qualifying hospital stay -- and only the first 20 days are fully covered. After that, there's a daily coinsurance of over $200.

Long-term custodial care (help with daily activities like bathing and dressing) is not covered by Medicare at all. That's what long-term care insurance or Medicaid is for.

Myth #10: "I don't need Part B if I'm healthy."

The truth: Part B covers doctor visits, outpatient care, preventive screenings, lab tests, mental health services, durable medical equipment, and much more. Even healthy people need checkups, screenings, and the occasional urgent care visit. And if you delay enrolling in Part B without qualifying coverage (like employer insurance), you'll pay a 10% penalty for every 12-month period you were eligible but didn't enroll -- for the rest of your life.

Myth #11: "Medicare and Medicaid are the same thing."

The truth: They're completely different programs. Medicare is a federal program for people 65+ (and some younger people with disabilities), regardless of income. Medicaid is a joint federal-state program for people with limited income and resources, regardless of age. Some people qualify for both ("dual-eligible") and receive extra financial help.

Myth #12: "Generic drugs are less effective than brand-name drugs."

The truth: The FDA requires generic drugs to have the same active ingredient, strength, dosage form, and route of administration as the brand-name version. They work the same way. Choosing generics through your Part D plan can save you hundreds or even thousands of dollars a year.

Myth #13: "I can enroll in Medicare any time I want."

The truth: Medicare has specific enrollment periods with real deadlines. Miss your Initial Enrollment Period and you may have to wait for the General Enrollment Period (January 1 - March 31), with coverage not starting until July. And as mentioned above, late enrollment can trigger permanent penalties.

Timing matters. A lot.

Myth #14: "Medicare Supplement (Medigap) and Medicare Advantage are the same."

The truth: These are two very different products. Medigap supplements Original Medicare by covering costs like deductibles and coinsurance. Medicare Advantage replaces how you get your Original Medicare benefits through a private plan. You cannot have both a Medigap policy and a Medicare Advantage plan at the same time.

Myth #15: "I don't need help choosing a plan -- I can just pick the cheapest one."

The truth: The cheapest plan is not always the best plan. A $0-premium Medicare Advantage plan might save you money monthly but cost more in copays, have a narrow provider network, or lack the extra benefits you actually need. The right plan depends on your medications, your doctors, your health conditions, and your lifestyle.

That's why working with a licensed, independent agent who can compare options across multiple carriers is so valuable -- and it doesn't cost you a penny, since agents are paid by the insurance companies, not by you.

The Bottom Line

Medicare is powerful, but it's not simple. The myths above lead to missed deadlines, unexpected bills, and coverage gaps that could have been avoided. The best defense? Good information and a little help from someone who knows the system inside and out.

Need help? At Insuras Health, we help seniors cut through the confusion and find the right Medicare plan -- no myths, no jargon, no pressure. Schedule a free consultation and let's make sure you're covered the way you deserve to be.