What's the most frustrating misconception you have to clear up with clients about Medicare every year?

Question

Kim Cotten · Accepted Answer

One of the most frustrating misconceptions I often have to clear up is the belief that Medicare is completely free and covers everything. Many clients are surprised to learn that Medicare has premiums, deductibles, copays, and that it doesn’t cover everything like dental, vision, hearing, or long-term care. Medicare plans are not a one size fits all and when i meet with my clients, i do a Client Needs Assessment to find the right plan for YOU.

Answered by Kim Cotten on May 5, 2025

Broker Licensed in FL, AL, AR & 40 other states

Answered by Kim Cotten Medicare Insurance Agent

Larry Dalton · Answer

First, It’s essential to clearly understand the differences between Traditional Medicare with a Medigap plan vs Medicare Advantage. 

Second item is the mistakenly think that starting with a low-cost plan is the best option; however, this isn’t always the case with insurance companies under the Medigap program. After the first four to five years, premiums can increase significantly, making it difficult for those with health issues to switch to a more affordable plan.  Often, individuals are left at point in life with no choice but to transition to an Advantage plan a more affordable monthly rate and giving up their freedom of choice.   Being informed about these options can lead to better long-term decisions regarding healthcare coverage.

Daniel Maisel · Answer

The most frustrating misconception about certain Medicare plans are the urban legends that are marketed by some Medicare health plans. 
What are those misconceptions? 

1) They receive all benefits in California, on those plans,  for FREE.

2) All doctors on those plans are located in one single location. 

If it may happen that all specialists they need work at one facility that would be true, but usually the patient must go to various facilities. 

3) All prescriptions are available at one facility. 

If they have their prescription available at the facility they happen to be at on the that day, then that is true.  If not, then they would then be required to travel to another location. 

In Southern California those in that popular plan,often may have to travel as much as a 50 mile radius.

When you are health that is not usually much of an issue. 

But it is important that plan selections should be made in the event they are ill.

Scott Sims · Answer

With so many plan changes this past year, many people who just let their plan roll into next year have been surprised by benefit changes. I make it clear when I sit down with clients and help them, let's make sure we have a chat or meeting when you get my postcard in the mail in September. These plans can change every year, it's important to review! Drug deductibles have changed this year for many plans, big deal!

Answered by Scott Sims on April 9, 2025

Broker Licensed in OR, AZ, CA & 15 other states

Answered by Scott Sims Medicare Insurance Agent

Nydia Flores · Answer

The most frustrating misconception is that Medicare covers all health insurance cost. 
This is not true, Medicare covers 80% of all medical cost, the customer is responsible for the other 20% of all medical cost, including co-pays.  The customers that purchase supplemental insurance like AARP or Medigap health insurance have more health coverage than those that do not purchase supplemental insurance.  The Medicare insurance covers 80% and the supplemental insurance (AARP/Medigap) covers the other 20%.  Having both health insurances Medicare & a supplemental insurance means that the customer is covered 100%.

Melanie Baxter Black · Answer

The most frustrating misconception that I have to clear up with clients about Medicare every year is that ALL Medicare Advantage plans are bad. This could not be further from the truth. If you have a Medicare Agent worth his weight in salt, the Agent will educate you about all of your options i.e. Medicare Supplements with a Part D plan -AND- Medicare Advantage plans, and explain to you the advantages and disadvantages of each and how it applies to your specific situation.

Answered by Melanie Baxter Black on April 3, 2025

Agent Licensed in TX

Answered by Melanie Baxter Black Medicare Insurance Agent

Diana Garner · Answer

The most frustrating misconception I have to clear up most of the time is that Medicare Advantage plans are horrible.

They are not horrible, they are just not explained properly by many agents who sell them, which leads to unhappy Medicare beneficiaries.

Medicare Advantage plans are good for people who are lower income and can't afford to pay monthly premiums for Medicare Supplements and Standalone Prescription Drug Plans.  If you do not go to the doctor often, your out-of-pocket expenses are less, however, we never know when something will happen or when we will become ill. There are ancillary products available with lower premiums that can help combat the copays for inpatient hospital stays, ambulance service copays, outpatient hospital surgeries, and more.

Medicare Advantage plans are also good for older beneficiaries who have reached the point where they are paying $300 - $400 per month for premiums on a med sup.  At that point, the max out-of-pocket on a Medicare Advantage plan is less than the monthly premiums they would be paying for a med sup.

John L Herman Jr · Answer

Truthfully it is getting past the bombardment of calls and mail they get from the Insurance companies that confuse the client...not educate the client.  Having people endlessly call...spout on TV...and slam them with mail harms them rather than helps them.

Callers assuring people that THEY have the best Plan even when someone else has a better Plan...this is ridiculous.

Eduardo Camacho · Answer

The most frustrating thing that I have run across is when people who turn 65 and believe that enrolling in a Part D prescription drug plan is optional and that there will be consequences if they don't

Chad Watkins · Answer

The most frustrating misconception that I have to clear up is that people think they can only change their Medicare supplement plan during the Annual Election Period (AEP).

Maureen McKenna · Answer

What is the difference between a Physical and a Wellness difference and which is covered by Medicare if any.

Jennifer Stark · Answer

That the deductible for certain drugs starts over Jan 1. They think they need to renew every year, and they get reallly nervous. I am always happy to explain how it works.

Marcie Barnes · Answer

The plan that is right for someone else may not be right for you.  A extensive needs assessment is the best way to determine what will be in your best interests.

Sam Silva · Answer

Delaying enrollment can lead to lifelong penalties, and that’s often something they don’t find out until it’s too late.
It takes time to help clients understand that planning ahead is essential to avoid unexpected expenses.
They often assume that once they turn 65, all their healthcare costs disappear, which unfortunately is not the case.

David Christian · Answer

That Medicare Advantage Plans are not as good as Med Supp plans. Neither option is for everyone, but I see a lot of people getting supplement plans that don't need to pay the higher premium costs (supplement + PDP plan) because they have heard the nightmares propaganda that some really popular sites have been saying for years. Each individual needs to evalutate the costs and coverages and don't just get a supplement because, "they costs more, so they are better".

Answered by David Christian on April 8, 2025

Broker Licensed in CA & TX

Answered by David Christian Medicare Insurance Agent

Karen Ansell · Answer

That Medicare will cover the full amount of their bill and that all insurance companies are the same.

Douglas Carney · Answer

The most frustrating misconception I have to clear up with clients about Medicare every year was the Doughnut Hole (if you know, you know). Now it's how the insurance carriers can afford to offer zero-dollar monthly plans.

Answered by Douglas Carney on May 9, 2025

Broker Licensed in FL, GA, NC, OK & TX

Answered by Douglas Carney Medicare Insurance Agent

Judi Norton · Answer

That once you are on a Medicare Advantage plan, every will remain the same from year to year. Also, that Medicare Advantage Plans should cover more and all doctors should take the plan if the Hospital or the Clinic takes the plan.

Answered by Judi Norton on April 11, 2025

Agent Licensed in NM

Answered by Judi Norton Medicare Insurance Agent

Jamie Herrick · Answer

Claim denial. I have not had any of my clients have any denials thus far. There is misinformation on tv. However it could be real for those under 65. But none of my clients have had denials.

Scott Klag · Answer

The most important misconception that clients have is that their plan will stay the same year over year. They don't think they need to review their plan on a yearly basis. Annual reviews during the AEP October 1 thru December 7 ARE ESSENTIAL!

Answered by Scott Klag on April 9, 2025

Agent Licensed in OH

Answered by Scott Klag Medicare Insurance Agent

Lesley Burns · Answer

As an agent, the most frustrating misconception is helping clients/potential client understand that I am not Medicare. I am a licensed professional working to answer all your questions and get them the best plan possible/available within the client service area.

Answered by Lesley Burns on April 9, 2025

Broker Licensed in AR, MI, MO, NM & TX

Answered by Lesley Burns Medicare Insurance Agent

Veronique Kasbarian · Answer

They do have the right to review their coverage every year at least with out having to change their doctors. As we get older our needs and health do change , thats why its important to review.

Ceranes Lejulus · Answer

Hmmm, let's see.... I think the most misconception clients have is that they think Medicare covers everything. I regularly have to educate that the Medicare was never designed to pay for everything. It's my job to try to minimize those out-of-pocket costs as much as possible.

Answered by Ceranes Lejulus on April 9, 2025

Broker Licensed in FL, AL, AR & 19 other states

Answered by Ceranes Lejulus Medicare Insurance Agent

Robert Rowe · Answer

Your OTC card isn’t for junk food it is For healthy food intended to be preventative health care spending. Your transportation benefits are for rides to your doctor appointments not to go on dates or run errands. Those are the 2 biggest ones.

Answered by Robert Rowe on May 13, 2025

Agent Licensed in MI

Answered by Robert Rowe Medicare Insurance Agent

Sonya Fortner · Answer

The most frustrating misconception that I have to clear up is that people think they can only change their Medicare supplement plan during the Annual Election Period (AEP).

Answered by Chad Watkins on May 14, 2025

Agent Licensed in NJ, AK, AL & 48 other states

Answered by Chad Watkins Medicare Insurance Agent

Christian Baird · Answer

The difference of Medicare supplement programs vs. Medicare Advantage. I do not offer Medicare Advantage plans because I do not believe in them.

Wes Drew · Answer

The most frustrating misconception is explaining that Medicare Supplements and Medicare Advantage plans are entirely different ways of looking at coverage. It isn't that one is better than the other, both plans are intended to serve the needs of beneficiaries while approaching those needs from different perspectives. There isn't a one-sized fits all plan for all Medicare beneficiaries and understanding your needs and expectations will help you determine which plan type is the right fit for you.

Answered by Wes Drew on April 9, 2025

Agent Licensed in IL

Answered by Wes Drew Medicare Insurance Agent

Bernadette Baugh · Answer

The most frustrating misconception is people think there's a cost to work with a local agent. Local agents are familiar with the networks and plans in your area. They're a fantastic resource to have. Each agent spends hundreds of hours a year researching plans, learning about new changes in the industry, and ultimately they want to help the members of his/her community. Building a relationship with your local agent will help eliminate a lot of frustrations that can come along with Medicare.

Answered by Bernadette Baugh on April 22, 2025

Agent Licensed in IN & FL

Answered by Bernadette Baugh Medicare Insurance Agent

Lachea Harris · Answer

People always think Medicare pays for everything, but it doesn't. They're shocked when they find out about all the stuff it skips, like dental and vision, and that it isn't free.

Patti Bagley · Answer

The most frequent question I get asked is about the extra grocery benefits that people see advertised. I feel that this is misleading because in order to qualify for these benefits you most likely also need to qualify for Medicaid or have a qualifying chronic illness.

Answered by Patti Bagley on April 8, 2025

Agent Licensed in PA & WV

Answered by Patti Bagley Medicare Insurance Agent

What's the most frustrating misconception you have to clear up with clients about Medicare every year?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

Related Questions

Agent Locator

Medicare Agents Hub
A non-government resource website

What's the most frustrating misconception you have to clear up with clients about Medicare every year?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

Related Questions

Agent Locator

Medicare Agents HubA non-government resource website

Medicare Agents Hub
A non-government resource website