Medicare rules are detailed enough that even well-informed people carry around a few outdated assumptions. Since health care costs are one of the biggest variables in retirement, it’s worth getting these right. Here’s how the common myths compare with the facts.

Myth: “Medicare is completely free.”

Fact: Most people don’t pay a monthly premium for Medicare Part A (hospital insurance) if they’ve worked and paid Medicare taxes long enough. But Part B (medical insurance), Part D (prescription drugs), and any supplemental coverage typically come with monthly premiums, deductibles, and copays of their own.

Myth: “Medicare covers long-term care, like an extended nursing home stay.”

Fact: Medicare covers only limited, short-term skilled nursing care following a qualifying hospital stay. It does not cover extended custodial long-term care. That kind of care is generally paid out of pocket, through long-term care insurance, or through Medicaid for those who qualify financially.

Myth: “I don’t need to sign up for Medicare if I’m still working past 65.”

Fact: This depends heavily on your employer’s size and the type of coverage you have. Missing your enrollment window without qualifying employer coverage can trigger late-enrollment penalties that last for the rest of your life. It’s worth confirming your specific situation rather than assuming you’re automatically covered.

Myth: “All Medicare Advantage plans work basically the same way.”

Fact: Medicare Advantage plans vary widely by insurer and even by county, with real differences in provider networks, premiums, drug coverage, and extra benefits. Comparing plans during open enrollment each year, rather than assuming last year’s plan is still the best fit, genuinely matters.

Myth: “Medicare covers me if I need care while traveling outside the U.S.”

Fact: Original Medicare generally does not cover health care received outside the United States, with only very limited exceptions. Some Medicare Advantage plans or supplemental policies offer limited foreign travel coverage, so it’s worth checking before an international trip rather than assuming you’re protected.

This article is educational and general in nature. It isn’t personalized health insurance or medical advice, and Medicare rules can change from year to year. Confirm current details at Medicare.gov or with a licensed Medicare advisor.