TONI SAYS: Exploring the myths of Medicare

By Toni King

Dear Toni:

I have been following your Toni Says Medicare column in my local newspaper 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. I appreciate your help. John, Las Vegas, NV

Hello John:

Thank you for emailing the information regarding the myths of Medicare. My answers to the myths are below:

Myth #1: A person can enroll in Medicare any time after they are 65 without penalty. FALSE!! This idea is wrong. If you are not working fulltime 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 “famous” Medicare Part B penalty of 10% for each 12-month period or year that you did not enroll in Part B. That penalty lasts for the rest of your Medicare life. (John since you are not working full-time for the company but have retirement benefits when turning 65, I would advise you to enroll in both Medicare Parts A and B for both to begin the 1st day of the month you turn 65.)

Toni Says: If you or your spouse are not working full-time with true employer benefits be sure to enroll in Medicare Parts A and B by the time you turn 65. If you wait 90 days past turning 65 and you will get a penalty.

Myth #2: Medicare is free. FALSE!! The Medicare payroll tax that you have been paying for years is for Medicare Part A only! Part B and Part D have a premium which is “means tested” based upon your income and your spouse’s income (if you filed jointly). Most on Medicare are paying the minimum required each month for Part B, but 10-15% of Medicare beneficiaries meet the means tested income amount and must pay more for their Medicare Part B and Medicare Part D premiums each month. If you do not pay the Part B or D premium, you will not have any of the Part B or D benefits.

Toni Says: Nothing is free!! You worked and paid taxes into the Social Security/Medicare systems.

Myth #3: Most baby boomers believe Medicare is just like group or individual health insurance plans. FALSE!! Original Medicare is completely different from group or individual health insurance. Medicare has two parts; Part A & B. Part A has a deductible that can be used up to 6 times a year for an inpatient hospital stay. Medicare Part B includes doctor’s office visits and doctor performing surgery, outpatient services and surgery, scans, x-rays, chemotherapy and radiation, wheelchairs, walkers, and the list goes on. Medicare Part B has a once-per-year deductible, with Medicare picking up 80% and you paying 20% of the Medicare approved charges, with no stop loss. Unlike the typical 80/20 to $5,000 with a stop loss for employer benefits, with Medicare, the 20% just keeps on going!!? That’s correct, no stop loss!

Toni Says: Original Medicare is completely different from health insurance, as we know it. The out-of-pocket costs can be huge.

John, you could have paid a penalty for the rest of your Medicare life if you had believed the Medicare myths. Remember with Medicare, “It’s what you DON’T know that will HURT You!”

Need Medicare help? Toni’s new Confused about Medicare video series is now available for purchase at and the Medicare Survival Guide discounted bundle package.