May 19, 2025 By: Shauna Soria
If you or a loved one is turning 65 and wondering how Medicare works, you’re not alone. As a licensed Medicare advisor, I help families every day who feel overwhelmed by all the conflicting information out there. That’s why I wanted to take a moment to clear up a few of the most common Medicare myths and facts — so you can feel confident about your next steps.
One big myth is that everyone over 65 automatically qualifies for Medicare. While most people do become eligible at age 65, it’s not automatic for everyone. If you’re still working and have employer-sponsored health insurance — or if you’re covered under Veterans Affairs or TRICARE — you may need to take special steps or delay enrollment to avoid unnecessary costs.
Another common misconception is that you can enroll in Medicare anytime after turning 65. In reality, you only get one Initial Enrollment Period (IEP). This is a 7-month window that begins three months before your 65th birthday and ends three months after. Missing it can lead to late enrollment penalties and delays in coverage, which many people don’t realize until it’s too late.
Many assume that once they have Medicare, it covers everything. But the truth is, Original Medicare does not cover long-term care, dental, vision, or hearing aids — all common needs as we age. That’s why many people choose to add a Medicare Supplement (Medigap) plan, a Part D prescription plan, or consider a Medicare Advantage plan to help with those out-of-pocket expenses.
Speaking of Advantage plans, it’s a myth that they’re always better. While Medicare Advantage plans often include extras like dental or gym memberships, they also come with network restrictions, prior authorization rules, and sometimes higher out-of-pocket costs depending on your health needs. Choosing between Original Medicare and Advantage should always be based on your specific situation — not a TV ad.
You may also have heard that Medicare can’t deny you coverage. While that’s mostly true for Parts A and B, it’s not always the case with supplemental coverage. If you apply for Medigap outside of your one-time protected window, you could be denied due to health conditions.
Another myth? That once you have Medicare, you don’t need anything else. In reality, most people benefit from adding drug coverage or a Medigap plan. These options can prevent financial surprises — especially during hospital stays or ongoing care.
And finally, Medicare isn’t the same for everyone. Your costs, coverage, and plan options can vary greatly based on where you live, your income, your health history, and what kind of plan you choose.
That’s where I come in. If you’re searching for answers about when to sign up for Medicare or need help comparing plans, I offer free consultations to walk you through every step. Whether you’re helping a parent turning 65 or planning ahead for yourself, I’ll help you avoid mistakes and feel confident in your decisions. Ready to make Medicare simple?
