What you don't know about Medicare can cost you

  • Nearly 9 out of 10 adults over age 50 are on Medicare or expect to enroll.
  • More than 70 percent of future retirees wish they had a better understanding of this retiree healthcare program.
  • In all, 58.5 million people were on Medicare Parts A and B in 2017, according to the Centers for Medicare & Medicaid Services.

Though Medicare is an essential part of retirement, pre-retirees continue to have misconceptions on how the federal program works.

Close to 90 percent of older Americans either enrolled in Medicare or plan to sign up for coverage, according to a recent survey from Nationwide Retirement Institute.

The insurer’s research arm worked with The Harris Poll to survey 1,007 adults over age 50 with a household income of at least $150,000.

More than 7 out of 10 participants said that they wish they better understood Medicare coverage.

“Health care costs are the biggest expense in retirement and should be a major factor when estimating retirement expenses, since they are often costly and unexpected,” said John Carter, president of retirement plans for Nationwide.

“It’s an opportunity for financial advisors to educate their clients and for consumers to ask questions,” he said.

Here are three major facts that even affluent pre-retirees are getting wrong about Medicare.

“Coverage for outpatient care is free.”

Your 50s are the prime of life and also a great time to ramp up retirement savings efforts.
Tom Merton | Getty Images
Your 50s are the prime of life and also a great time to ramp up retirement savings efforts.

More than half of the individuals in the poll did not know that Medicare Part B — which covers doctor’s services and outpatient care — is not free.

Nearly 3 in 10 of the participants believed Medicare costs the same for everyone.

It’s not true.

The standard Part B premium amount is $134 per month in 2018 for singles with a modified adjusted gross income (MAGI) of $85,000 or less in 2016 ($170,000 for married joint filers).

High-income beneficiaries can expect to shell out more for this coverage. See below.

Participants in Medicare’s program for prescription drugs, or Part D, can expect to pay more if their 2016 MAGI exceeded $85,000 ($170,000 if married).

Part A, hospital insurance, is free if you and your spouse paid Medicare taxes while you were working.

There is also Medigap, which supplements Part A and B, helping you handle the cost of deductibles and copays, as well as offering you coverage you may not otherwise receive through your plans.

“You can enroll at any time.”

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More than 20 percent of the participants erroneously believed you could sign up for Medicare whenever you want.

The reality is that you have a seven-month initial enrollment period once you first become eligible for Medicare to sign up for the program. That seven-month period kicks off three months before the month in which you turn 65 and ends three months after your 65th birthday.

Medicare also offers another opportunity to sign up during a “general enrollment period” from Jan. 1 to March 31.

Special enrollment periods are available for those who have coverage under a workplace plan and who may not need to apply for Medicare at age 65.

Keep an eye on your calendar: Failure to sign up for Medicare Part B when you’re first eligible and no qualifying exceptions may result in a penalty. Your premium may go up 10 percent for each year that you could’ve had coverage but failed to sign up for it.

You’ll be paying this higher premium as long as you are enrolled in the program.

“You can’t switch plans.”

A sample medicare benefit card and prescription drugs card.
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A sample medicare benefit card and prescription drugs card.

More than a third of participants believed that once you’ve signed up for Medicare, you’re stuck with the plan you’ve selected.

That’s not true.

Medicare open enrollment — which runs from Oct. 15 to Dec. 7 — gives beneficiaries a chance to swap from Medicare Parts A and B to an Advantage Plan (known as Medicare Part C), or to shift from an Advantage Plan to Parts A and B.

You can also change your existing Advantage Plan or change your Part D plan.

Even if you’re happy with your plan, you should review it every year and shop around: Premiums, deductibles and copayments can change.

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