Welcome to Benefit Design Services’ latest exploration into the world of Medicare, where we aim to shed light on common myths and misconceptions that often cloud the understanding of this vital healthcare program. Whether you’re in West Virginia, or across the Ohio and Kentucky borders, it’s crucial to separate fact from fiction to make the most informed decisions regarding your healthcare coverage.

Myth 1: Medicare Covers All Health Expenses

One of the most pervasive myths is that Medicare will cover all your healthcare expenses in retirement. However, while Medicare provides a broad range of benefits, it does not cover everything. For instance, long-term care, most dental care, eye examinations related to prescribing glasses, dentures, cosmetic surgery, acupuncture, and hearing aids are not covered. Beneficiaries are also responsible for deductibles, co-pays, and coinsurance, which can add up. This is where supplemental policies, like Medigap or Medicare Advantage plans, offered by Benefit Design Services, become essential in covering those additional costs.

Myth 2: Medicare is Free

Many people in the tri-state area believe that Medicare comes without any cost. This misconception likely stems from the fact that Part A (Hospital Insurance) is premium-free for most beneficiaries. However, Part B (Medical Insurance) requires a monthly premium that varies based on your income. Additionally, Part D (Prescription Drug Coverage) and Medicare Advantage plans (Part C) also come with their own set of premiums, deductibles, and co-pays. Understanding these costs is vital for budgeting for healthcare expenses in retirement.

Myth 3: You Can Enroll in Medicare Anytime After You’re 65

Another common myth is that there’s no rush to enroll in Medicare once you turn 65. However, there are specific enrollment periods. The Initial Enrollment Period (IEP) is a seven-month window around your 65th birthday. Missing this window without having other credible coverage could lead to penalties and gaps in coverage. Benefit Design Services can help you navigate these enrollment periods to ensure you’re covered when you need it.

Myth 4: Medicare is Only for the Elderly

While it’s true that Medicare is primarily for individuals 65 and older, it’s not exclusively for them. People under 65 with certain disabilities or End-Stage Renal Disease (ESRD) are also eligible for Medicare. This inclusivity ensures that many residents within West Virginia and the surrounding tri-state area, who may not be of retirement age but are dealing with significant health challenges, have access to healthcare coverage.

Myth 5: Medicare Part C is a Separate Benefit You Add to Original Medicare

Some people believe that Medicare Advantage (Part C) is an additional benefit you can purchase on top of Original Medicare. In reality, Medicare Advantage is an alternative way to receive your Medicare benefits. These plans are offered by private insurance companies approved by Medicare and often include additional benefits like dental, vision, and hearing coverage. Benefit Design Services can help compare these plans to find the best fit for your healthcare needs and lifestyle.


Navigating Medicare’s complexities doesn’t have to be a solitary journey. At Benefit Design Services, we’re dedicated to providing the residents of the tri-state area of West Virginia, Ohio, and Kentucky, with the information and support needed to make informed Medicare decisions. By debunking these common myths, we aim to empower you with clarity and confidence in your healthcare coverage choices.

For personalized guidance and to ensure you’re fully leveraging your Medicare benefits, contact Benefit Design Services. Our team of experts is ready to assist you in navigating the Medicare landscape, ensuring you’re well-informed and well-prepared for the road ahead.