Common Medicare Myths and Misconceptions That Could Cost You

Most Medicare beneficiaries are leaving money on the table without realizing it. Whether it's skipping annual plan comparisons, misunderstanding what Medicare Advantage dental benefits actually cover, or assuming all Medigap plans cost the same, widespread myths about Medicare lead to poor decisions and unnecessary expenses every year. Here's what you need to know to avoid the most common traps.

Myth #1: You Don't Need to Compare Plans Every Year

This is the most expensive myth in Medicare. According to a KFF analysis, nearly 7 in 10 Medicare beneficiaries did not compare their coverage with other options during the most recent open enrollment period. Among those enrolled in Medicare Advantage prescription drug plans, 82% made no comparisons at all.

Plan benefits, premiums, formularies, and provider networks change every year. A plan that was a great deal last year may not be competitive this year. Medicare's Plan Finder tool makes it straightforward to compare Medicare Advantage plans side by side, and the process can potentially save you hundreds of dollars annually.

Myth #2: Medicare Advantage "Free Dental" Means Full Coverage

Many Medicare Advantage plans advertise dental benefits as a major perk, and they are — but the reality often falls short of what people expect. Dental coverage embedded in Medicare Advantage plans varies wildly from plan to plan. Some cover up to $3,000 or more per year, while many cap annual dental benefits at $1,000 or less.

Most plans cover preventive care like cleanings and exams, but major procedures like implants, crowns, and dentures are frequently excluded or subject to steep limits. Before assuming your Medicare Advantage plan has you covered, read the fine print carefully. If you need more robust dental care, a stand-alone dental insurance policy may be a better fit.

Myth #3: All Medigap Plans With the Same Letter Cost the Same

Medigap (Medicare Supplement) plans are standardized by letter — Plan G is Plan G no matter which insurance company sells it. But the premiums are not standardized. Different insurers can charge very different prices for the exact same coverage, and pricing methods vary as well (community-rated vs. issue-age vs. attained-age).

In many markets, the gap between the cheapest and most expensive Medigap plan for the same letter can be double or more. Shopping around — especially during your 6-month Medigap open enrollment window when you can't be turned down for pre-existing conditions — can result in significant long-term savings.

Myth #4: Your Part D Drug Plan Doesn't Need to Change

Every year, Medicare Part D plans adjust their formularies, tier structures, preferred pharmacies, and premiums. A drug that was Tier 1 (lowest cost) this year might move to Tier 3 next year, dramatically increasing your out-of-pocket costs.

In 2026, there are significant changes beneficiaries should be aware of:

• New $2,100 annual out-of-pocket cap on Part D prescription drug spending, thanks to the Inflation Reduction Act
• Average stand-alone Part D premiums have dropped from $38.31/month in 2025 to $34.50/month in 2026
• Out-of-pocket costs for certain negotiated drugs have declined by roughly 50% compared to 2025

These changes mean your current plan might no longer be the best option — or a plan that was previously too expensive may now be a better deal. Reviewing your Part D coverage during the Annual Enrollment Period (October 15 – December 7) is one of the easiest ways to save money.

Myth #5: All Medicare Plans Are Basically the Same

According to KFF, the average Medicare beneficiary has access to 39 different Medicare Advantage plans for 2026 — and over 99% of beneficiaries have access to at least one plan. But those 39 options are far from interchangeable.

Plans differ in premiums, deductibles, copays, out-of-pocket maximums, provider networks, drug formularies, and extra benefits like vision, hearing, dental, and fitness programs. An HMO plan that works perfectly for someone who rarely leaves their home area may be a poor fit for someone who travels frequently or splits time between states.

The key takeaway: don't assume any plan is "good enough" without comparing. Your health needs, medications, preferred doctors, and budget should all factor into the decision.

What You Can Do Right Now

Avoiding these myths starts with being proactive about your Medicare coverage:

• Review your plan every year during the Annual Enrollment Period (October 15 – December 7). Benefits, costs, and formularies change annually.
• Use Medicare's Plan Finder at medicare.gov/plan-compare to compare plans in your area.
• Read the dental fine print on any Medicare Advantage plan before assuming you're fully covered.
• Shop around for Medigap — don't accept the first quote you see. Get at least 3–4 quotes for the same letter plan.
• Check your Part D drug list every fall. Make sure your medications are still covered at the tier you expect.
• Talk to a licensed agent who can help you navigate your options. A local Medicare agent can review your specific situation and find the right plan for your needs.