UNITED STATES—Toni: I have been following your “Toni Says®” Medicare article in my local newspaper learning about Medicare. This week I was mailed information discussing different myths of Medicare that confused me even more. I have been diagnosed with Parkinson’s and want to be sure I make the correct choice.

I do not understand why I need to enroll in Medicare, since I have excellent company retirement health insurance. Please help me understand these Medicare myths. Appreciate your help, John from Bellaire, TX.

Hello John: Thank you for emailing the information regarding myths of Medicare. My answers to the myths are below:

  • Myth #1 A person can enroll in Medicare any time after they are 65 without penalty. FALSE!! This idea is wrong. If you are not working fulltime for a company with true group benefits or have an individual health insurance plan and wait later than 65 years old and 90 days to enroll in Part B, then you can receive a penalty of 10% for each 12-month period or year that you did not enroll in Part B. That penalty lasts for the rest of your Medicare life.

John since you are not working fulltime for the company you have retirement benefits when turning 65, I would advise you to enroll in both Medicare Parts A and B.

Toni Says®:  If you or your spouse are not working fulltime with true company benefits be sure to enroll in Parts A and B by the time you turn 65. Wait 90 days past turning 65 and you will get a penalty.

  • Myth #2: Medicare is free. FALSE!! The Medicare payroll tax that you have been paying for years is for Medicare Part A only! Part B has a premium which is means tested due to your income and your spouse’s income (if you filed jointly). Most on Medicare are paying the minimum required each month for Part B, but 10% of Medicare beneficiaries meet the means tested income amount and must pay more for their Medicare Part B premiums each month. If you do not pay the Part B premium, you will not have any of the Part B benefits.

 Toni Says®:  Nothing is free!! You worked and paid taxes into the Social Security system.

  • Myth #3: Most baby boomers believe Medicare is just like group or individual health insurance plans. FALSE!! Medicare is completely different than traditional group or individual health insurance. Medicare has two parts; Part A & B. Part A has a deductible that can be used up to 6 times a year for an inpatient hospital stay. Medicare Part B includes doctor’s services such as office visits and doctor performing surgery, outpatient services and surgery, scans, x-rays, chemotherapy and radiation, wheelchairs, walkers, and the list goes on. There is a deductible for Medicare Part B that is a once per year deductible, with Medicare picking up 80% and you pay 20% of the Medicare approved charges, with no co-insurance or stop loss. Not like the typical 80/20 to $5,000 with a stop loss, that most have been familiar with their adult life. With Medicare the 20% just keeps on going!!? That’s correct, no stop loss!

 Toni Says®:  Medicare is completely different than health insurance. The out of pocket can be huge.

  • Myth #4… Medicare covers everything. FALSE Medicare only covers what is medically necessary. Does not cover long term care, routine dental care, cosmetic surgery, hear aids and acupuncture.

Toni Says®: If Medicare doesn’t pay, then your Medicare supplement or Medicare Advantage plan will not pay either.

For a Medicare Checkup, call the Toni Says® Medicare call center at 832/519-8664 or email info@tonisays.com regarding your Medicare plans and options. Toni Says® Medicare Survival Guide is available at www.tonisays.com.