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5 Misconceptions About Medicare Coverage

5 Misconceptions About Medicare Coverage

April 28, 2021

The United States national health insurance program, Medicare offers coverage to seniors age 65 and older and some younger people with disabilities. Although this program is widely used by millions of people throughout the country, there are many misconceptions about this coverage. To learn about this program, look at the facts behind the following misconceptions. 


  1. Myth: Medicare Is Free


Truth: Unfortunately, Medicare is not completely free. If you earned enough credits during your career, you receive part A without paying any premiums, but if you don't have enough credits, you have to pay a monthly premium for this coverage. Note that as a general rule of thumb, you must have worked for 10 years to avoid premiums. 


For Part B, everyone pays a monthly premium, and if you decide to get Parts C or D, you also have to pay premiums for these plans. Additionally, you face coinsurance and deductibles for services received under all the Medicare programs. 


  1. Myth: Medicare Covers Dental Care


Truth: Medicare does not cover most dental care.This insurance does not cover most routine dental care, fillings, or extractions. However, you may be able to get coverage for dental services you receive as an inpatient while in a hospital. 


  1. Myth: Medicare Covers Extended Hospital Stays


Truth: Medicare Part A covers inpatient hospital stays, but there are strict limits on this coverage. As of 2020, Medicare recipients must pay a $1408 deductible on fees incurred during hospital stays for every benefit period. After you meet your deductible, you can stay in the hospital for up to 60 days, and you don't owe any coinsurance. 


On days 61 through 90 in the same benefit period, you will owe $352 per day. If you're in the hospital over 90 days, you owe $704 per day for coinsurance for day 91 and onward, but in this category, you can only use up to 60 days over your lifetime. Once you cross the 60-day threshold of hospital stays over 90 days per benefit period, you are responsible for all the costs. 


  1. Myth: Medicare Doesn't Cover Long-Term Nursing Care. 


Truth: Just as Medicare doesn't cover extra extended hospital stays, the program also doesn't cover long-term nursing care. In some cases, you can get coverage for up to 100 days in a skilled nursing facility. 


Beyond that, if you need to move into a nursing home, you must pay on your own. Eventually, you may be able to have Medicaid cover your nursing home stay, but to qualify, your assets and income must be under a certain threshold. 


  1. Myth: If You Have Medicare, You Don't Need Other Coverage. 


Truth: As you can see, there are a lot of gaps in Medicare coverage. If you want to ensure that you have the coverage you need, you may want to sign up for additional insurance policies. In particular, if you don't want to risk spending all your income and liquidating your assets to cover the cost of care in a nursing home, you may want to invest in long-term care insurance. 


All information is believed to be from reliable sources; however LPL Financial makes no representation as to its completeness or accuracy.


The opinions voiced in this material are for general information only and are not intended to provide specific advice or recommendations for any individual.


The information provided is not intended to be a substitute for specific individualized tax planning or legal advice. We suggest that you consult with a qualified tax or legal advisor.














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