Medicare doesn't start automatically, isn't free, and plan choices vary by network, cost, and broker bias. Missing key deadlines triggers lifetime penalties. Bust these five myths to protect your wallet and doctor access.
Auto-Start? • "Free" Cost Myth • Advantage Plan Differences • Broker Bias • Switch-Whenever Myth • FAQ
1. Does Medicare start automatically at 65?
Truth
Medicare starts automatically only if you already collect Social Security. Everyone else must enroll during a 7-month Initial Enrollment Period (IEP) around their 65th birthday. Miss it and Part B & D penalties last for life.
How to stay safe
1. Mark your personal deadline six months before you turn 65 and enroll for the first time.
2. If still working, get a letter proving your employer coverage is "creditable."
If you're new to Medicare, we won't sugarcoat it: Medicare is kind of a letdown when it comes to dental care.
With MyALEXHealth™
Enter your birth month once; ALEX® flags your exact IEP and any penalty risk.
2. Is Medicare really free?
Truth
Part A is premium-free for most, but Part B costs $202.90/mo in 2026 and climbs with Income-Related Monthly Adjustment Amount (IRMAA) surcharges when income tops $109k for single filing or $218k for joint filing. Add drug and supplemental coverage and costs often exceed employer plans.
How to stay safe
1. Project total annual cost: premiums + drug spend + deductibles + maximum out of pocket (MOOP) + IRMAA.
2. Time large Roth conversions or stock sales to avoid IRMAA bracket jumps.
With MyALEXHealth
See a single screen showing premiums, drug tiers, IRMAA, and worst-case MOOP.
3. Are all Medicare Advantage plans basically the same?
Truth
Networks, drug formularies, extras, and annual MOOP caps vary dramatically, even within one ZIP code. Choosing wrong when you first enroll during your IEP or SEP, or if switching during the Annual Enrollment Period (AEP), can strand your doctor or meds out-of-network for a full year.
How to stay safe
1. Verify every doctor, pharmacy, and medication against each plan.
2. Compare each plan's MOOP to gauge worst-case risk.
With MyALEXHealth
Real-time provider and drug matching spots mismatches before you click Enroll.
4. Are brokers "free" with no downsides?
Truth
Brokers are paid by carriers. Good ones disclose all plans, but many highlight higher-commission options. Studies show retirees rarely see every plan they’re eligible for.
How to stay safe
1. Request a written list of all available plans and broker commissions.
2. Cross-check recommendations with an unbiased digital comparison tool to check the math.
With MyALEXHealth
Plan-agnostic guidance = no commissions in the algorithm.
5. Can I switch plans anytime if I don't like mine?
Truth
For Medicare Advantage plans, most people get one AEP (Oct 15 – Dec 7) to change plans for the next year. Medigap carriers can underwrite—or deny—you after your initial six-month enrollment window.
How to stay safe
1. Value freedom? Pair Original Medicare with Medigap while you're healthy.
2. If on a Medicare Advantage plan, set a calendar reminder every October to review options, even if things feel fine.
With MyALEXHealth
Side-by-side comparisons show lock-in rules and underwriting risk before you commit.
FAQ
What happens if I miss my Initial Enrollment Period?
You may face a 10% lifetime surcharge for every 12 months without Part B and a 1% per-month surcharge on Part D after a 63-day gap.
Can IRMAA be appealed?
Yes. File SSA-44 if you had a life-changing event like retirement, marriage, or income drop.
Is Medigap ever guaranteed after 65?
Only during your six-month Medigap Open Enrollment Period or specific Special Enrollment Periods in select states.
Remember: Medicare isn't automatic, isn't free, and picking the wrong plan can lock you into big costs. Use MyALEXHealth to check deadlines, IRMAA, networks, and MOOP so you enroll penalty-free and stress-free.
Next steps—without the headaches
Avoiding these five traps is about seeing the math and trade-offs before you enroll for the first time, or if you’re on a Medicare Advantage plan and want to switch, during AEP. MyALEXHealth delivers crystal-clear numbers, jargon-free explanations, and plan comparisons you can trust.
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