Medicare is complicated and it can be easy to make erroneous assumptions about coverage and enrollment. Below, Tatiana Fassieux, our Education & Training Specialist, reviews the nine most common myths and “Medicare mistakes” with information on how to avoid them.
1. If I delay my Social Security pension, I can also delay my Medicare enrollment.
Not true, yet this is a common mistake people make. The ONLY legitimate way to delay Medicare enrollment, specifically Medicare Part B (outpatient medical), is if you are covered by “active” employment health care. That is, you, or your dependent spouse, have coverage while working and are covering the Medicare eligible individual. Once the covered individual, or in this case, you or your spouse, stops working, even if you get COBRA coverage, you must enroll in Medicare to avoid a late enrollment penalty. If you delay Medicare Part B enrollment due to employment, you have 8 months to enroll in Medicare Part B from when your active employment stopped. You can enroll in Part A, if you have sufficient Social Security credits at any time.
2. Medicare covers health care in a foreign country
Not true. Medicare does not cover health care in a foreign country. If you are planning to travel in a foreign country, we advise you purchase health insurance to cover emergencies while traveling abroad.
3) Having a plan through Covered California excuses me from enrolling in Medicare.
Not true. Even though the Federal “individual mandate” for coverage has been rescinded, having a plan through the Covered California exchange does NOT prevent Medicare’s late enrollment penalties if you delay Medicare enrollment when eligible. For more information, read our previous 4-part series of articles: What to Do If You Have Covered California & Become Eligible for Medicare? Part 1, Part 2, Part 3, Part 4.
4) I am self-employed with an individual health plan policy, so I can delay my enrollment into Medicare Part B.
Not necessarily true. Unless the policy is a “group” policy that covers “actively employed” individuals, you too may be assessed a late enrollment penalty if you delay Medicare enrollment when you’re first eligible at age 65.
5. Medicare is the “enrollment agency.”
Not true. Medicare enrollment must always be done through the Social Security Administration (SSA), either in person or online at www.ssa.gov. You must set up a login and password on the SSA website to enroll online.
6. I can continue contributing to my Health Savings Account (HSA) even though I am enrolled in Medicare.
Not true. When you’re about to enroll in Medicare, contributions to your HSA must stop within 6 months prior to your Medicare Part A enrollment. You can, however, reimburse yourself for certain medical expenses according to the appropriate tax laws. Make sure to consult with your tax advisor.
7. I can enroll in Medicare any time after I turn 65.
Not true. There are specific times when you can enroll in Medicare: These include:
- Initial Enrollment Period (IEP), which lasts 7 months – 3 months prior to your birthday month, your birthday month, and 3 months following your birthday month
- General Enrollment Period (GEP), which is January to March 31, and Medicare will be effective July 1.
- Special Election Period (SEP), which starts 8 months following loss of active employment coverage; COBRA or retiree coverage doesn’t count.
8. I can enroll in Medicare during the Open Enrollment which runs October 15 through December 7 each year.
Not true. This Open Enrollment period is also called the Annual Election Period (AEP) and is the time when someone already enrolled in Medicare can elect or change their prescription drug coverage, or how they get their Medicare benefits through a Medicare Advantage plan, like an HMO. Another time a person already enrolled in Medicare can change their Medicare Advantage plan is during the Medicare Advantage Open Enrollment (MAOEP) which is January 1 through March 31 each year.
9. As a Medicare eligible person, I can enroll in a Medicare Supplement any time during the year.
Yes, this is true, if you have no pre-existing conditions. If you do have a pre-existing condition, however, an insurer selling Medicare supplement plans can deny you coverage. The best time to buy a Medicare Supplement (Medigap) is within the first 6 months of being enrolled in Medicare Parts A and B. During this time, you have an open enrollment period to buy a Medigap plan without a health screening. This means you cannot be denied coverage because of a pre-existing condition.
Approaching Medicare Eligibility & Still Have Questions? HICAP Can Help
If you are approaching Medicare eligibility and have questions, the Health Insurance Counseling & Advocacy Program (HICAP) can help. HICAP is California’s federally funded State Health Insurance assistance Program (SHIP). They offer free, individual and unbiased assistance on Medicare and other health insurance related questions. HICAP’s phone number is 800-434-0222. You can also find your local county HICAP’s contact info online. Additional helpful information is on our California Health Advocates website.
