15 Common Medicare Myths That Cost People Money

“When I turn 65, Medicare just starts on its own.”

The truthIt starts automatically only if you're already drawing Social Security (or Railroad Retirement) benefits before 65. Since more people now wait until 67 to 70 to claim Social Security for a bigger check, most folks have to actively sign themselves up. If no one tells you that, your window can quietly close.

“I'll sign up for Medicare whenever I get around to it.”

The truthYour first chance is a 7-month Initial Enrollment Period: the 3 months before your 65th-birthday month, that month, and the 3 months after. Miss it without other qualifying coverage and the Part B late penalty adds 10% to your premium for each full year you waited, for as long as you have Part B. It never goes away. Here's exactly how the window works.

“That Medicare 'open enrollment' I see advertised every fall is when I first sign up.”

The truthThe fall window (Oct 15–Dec 7) is the Annual Enrollment Period, and it's only for people already on Medicare to change drug or Advantage plans. It does not enroll you for the first time. Don't confuse it with the Healthcare.gov (ACA) marketplace open enrollment either. That's a separate program. Every Medicare window, explained.

“I have COBRA (or my retiree plan), so I can put off Part B with no penalty.”

The truthOnly active employer coverage from a job with 20 or more employees (yours or your spouse's) lets you safely delay Part B. COBRA and retiree coverage do not count. Your 8-month Special Enrollment Period starts when the job ends, not when COBRA runs out. Riding COBRA too long is one of the most expensive mistakes I see. More on working past 65.

“Part A is free, so I should grab it the moment I turn 65.”

The truthFor most people Part A is premium-free, but signing up for any part of Medicare, including Part A, ends your ability to contribute to a Health Savings Account (HSA). And if you enroll after 65, Part A can backdate up to 6 months, which can turn recent HSA deposits into a tax headache. Still working and contributing to an HSA? Stop about 6 months before you enroll.

“Medicare Advantage and a Medicare Supplement are pretty much the same thing.”

The truthThey're opposites. A Medicare Supplement (Medigap) works alongside Original Medicare and pays your share of the bills, letting you use any doctor in the country that takes Medicare. Medicare Advantage (Part C) replaces how you get your benefits, through a private plan with a network and often prior approval for services. You can't use both at once. The real difference, side by side.

“I'll start with Medicare Advantage and switch to a Supplement later if I want.”

The truthYou can change plans each year, but getting a Supplement later usually means passing medical underwriting in Kentucky. If your health has changed, you can be charged more or turned down. The one time a company can't say no is your 6-month Medigap window when you first get Part B at 65. This is the single most important thing to understand before you choose.

“Those $0-premium Advantage plans are free.”

The truth“$0 premium” only means the plan adds nothing on top of your Part B premium, which almost everyone still pays ($202.90 a month in 2026). It says nothing about what it costs to use the plan: copays, coinsurance, the network, and prior-authorization rules all still apply.

“Medicare is free. I paid into it my whole life.”

The truthYour payroll taxes earn you premium-free Part A (hospital) if you worked about 10 years. But Part B (doctors) has a monthly premium of $202.90 in 2026, plus deductibles, coinsurance, and drug-plan costs. Medicare is a tremendous help, but it isn't free, and it isn't complete. Here's what you'll actually pay.

“Everyone pays the same Medicare premium.”

The truthHigher earners pay an extra amount called IRMAA on Part B and Part D, based on your tax return from two years ago. And it's a cliff: going one dollar over a threshold (in 2026, $109,000 single / $218,000 married filing jointly) bumps you to the full surcharge. Good news: if your income dropped after you retired, you can ask Social Security to use your newer, lower income (Form SSA-44).

“There's still a Medicare 'donut hole' I'll fall into.”

The truthThe donut hole was eliminated in 2025. Now your out-of-pocket cost for covered Part D drugs is capped at $2,100 in 2026, and after that you pay $0 for covered drugs the rest of the year. One catch: that cap is about drug costs, not your monthly drug-plan premium, which you keep paying. What changed for 2026.

“I don't take any prescriptions, so I'll skip drug coverage.”

The truthIf you go without creditable drug coverage and add Part D later, you'll owe a penalty of 1% of the base premium for every month you went without, added to your premium for life. A low-cost drug plan now is almost always cheaper than the lifelong penalty later, and it's there the day you do need a prescription.

“Medicare will pay for the nursing home when Mom can't care for herself.”

The truthThis is the costliest myth of all. Original Medicare does not pay for long-term custodial care, the everyday help with bathing, dressing, and eating. It covers only a short, skilled stay: up to 100 days per benefit period, after a qualifying 3-day inpatient hospital stay, with days 21–100 costing $217 a day in 2026. Long-term care is generally paid by Medicaid or private long-term-care insurance.

Watch outNights spent in the hospital under “observation” status don't count toward that 3-day requirement, even if you're in a bed overnight. Always ask whether you've been formally admitted as an inpatient. All the gaps, and how to fill them.

“Medicare covers my dental, vision, and hearing.”

The truthOriginal Medicare generally doesn't cover routine dental care, eye exams or glasses, or hearing aids, three of the things seniors use most. Some Medicare Advantage plans add limited versions of these, and standalone dental and vision coverage can be bought separately.

“Medicare covers me when I travel out of the country.”

The truthIn most cases, Original Medicare won't pay for care outside the U.S. A few Medigap plans include limited foreign-travel emergency coverage, and many travelers buy a separate travel medical policy for trips and cruises.