November 30, 2023 - 10:58 am
Dear Toni: I have been following your Toni Says column to learn about Medicare. This week I discovered online information discussing different myths of Medicare that confused me even more. I have 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. — John, Las Vegas
Dear John: Thank you for emailing about the myths of Medicare. Let’s dispel three of the most common ones:
■ Myth: A person can enroll in Medicare anytime after they are 65 without penalty.
■ Truth: If you are not working full time for a company with true group benefits, or if you 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 the infamous Medicare Part B penalty of 10 percent for each year that you did not enroll. That penalty lasts for the rest of your Medicare life.
John, since you are not working full time, I would advise you to enroll in Medicare Parts A and B for both to begin the first day of the month you turn 65, even though you will have retirement benefits when turning 65.
■ Myth: Medicare is free.
■ Truth: The Medicare payroll tax that you have been paying for years is for Part A only. Parts B and D have a premium that is means-tested based upon your and your spouse’s income (if you filed jointly). Most people on Medicare are paying the minimum required each month for Part B, but 10 percent to 15 percent of Medicare beneficiaries meet the means-tested income amount and must pay more for Part B and Part D each month. If you do not pay the premiums, you will not receive any of the benefits.
■ Myth: Medicare is just like group or individual health insurance plans.
■ Truth: Original Medicare is completely different from group or individual health insurance. Medicare has two parts: A and B. Part A has a deductible that can be used up to six times a year for an inpatient hospital stay. Part B includes doctor’s services such as office visits, outpatient services and surgery, scans, X-rays, chemotherapy and radiation, wheelchairs, walkers, the list goes on. Part B has a once-per-year deductible, with Medicare picking up 80 percent and you paying 20 percent of the Medicare-approved charges, with no coinsurance or stop-loss.
Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email firstname.lastname@example.org or call 832-519-8664.