Fair Square Medicare Wordmark

Why Is Medicare So Confusing?

bearded man holding his head in confusion looking at his laptop stock image
By Daniel Petkevich
Apr 19, 2023

We can help navigate the minefield of Medicare

For people new to the world of Medicare, it might feel like you need an advanced degree to understand even the basics. You’ve got Parts A and B to make up Original Medicare. Part C is also known as Medicare Advantage and can contain Parts A and B (and Part D in some circumstances). Then with Medicare Supplement (also known as

Medigap

) Plans F, G, and N are among the most common, but there are many more plans you could theoretically choose from. Not to mention that for many people, this is their first experience with health insurance that isn’t tied to their employer. These are just some of the factors that lead to Medicare confusion. In this blog post, we’re going to talk about more sources of misunderstanding and provide some remedies for your headaches.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Factors Contributing to Medicare Confusion

Medicare

is a federal health insurance program that is governed by complex rules and regulations. The program is divided into several parts, each with its own set of rules and regulations that can be difficult to parse through. Medicare Part A covers hospital stays, skilled nursing facility care, hospice care, and home health care, but only under certain circumstances and with specific limitations. Medicare Part B covers medically necessary services and preventative care but may require prior authorization and may have different coverage and cost-sharing rules depending on the service. To simplify, think of Part A as hospital insurance and Part B as medical insurance. 
Additionally, Medicare Advantage plans have their own set of rules and regulations that can be confusing for beneficiaries to navigate, like

HMO and PPO networks

. Failing to understand and follow these rules can result in denied claims, unexpected out-of-pocket costs, and missed opportunities for coverage.
One of the biggest sources of confusion for Medicare beneficiaries is the coverage limitations and gaps. While Medicare covers a wide range of medical services, it doesn't cover everything, and some services may have limitations or requirements that can be difficult to navigate. For example, Medicare doesn't cover everything you might be used to on your private insurance, such as vision, dental, or acupuncture (although some Medicare Advantage plans might have dental or vision benefits). Understanding these gaps in coverage and how to fill them can be a challenge for many Medicare beneficiaries, leading to frustration and unexpected out-of-pocket costs.
Another source of confusion for Medicare beneficiaries is the challenge of changing policies due to limited enrollment windows and

different enrollment periods

. For example, Medicare beneficiaries who want to switch from Original Medicare to a Medicare Advantage plan or vice versa can only do so during specific enrollment periods. Missing these enrollment windows can result in being stuck with a plan that no longer meets their needs. Furthermore, changing from a Medicare Advantage plan to a Medicare Supplement plan may require going through

medical underwriting

, which can be a time-consuming and stressful process, especially for those with pre-existing conditions.
In addition to enrollment windows, Medicare policies and regulations are subject to change, often without much notice. This can be particularly frustrating for beneficiaries who have become accustomed to certain benefits or coverage options, only to have them altered or eliminated. Keeping up with these changes can be a daunting task, especially for those who may not have access to reliable information or resources.
Overall, the complexities and limitations of Medicare enrollment and policy changes can be overwhelming for many beneficiaries, requiring careful planning and attention to detail to ensure that they are getting the coverage they need.

Consequences of Medicare Confusion

Medicare confusion can have several negative consequences for beneficiaries, including:
Difficulty in making informed decisions: With so many different plans, coverage options, and regulations, it can be challenging for beneficiaries to make informed decisions about their healthcare coverage. This can lead to frustration, stress, and a lack of confidence in their choices.
Possibility of missing out on benefits: Medicare beneficiaries who are confused about their coverage may miss out on important benefits or services to which they are entitled. For example, they may not be aware of preventative services that are covered under Medicare, or they may not know that they can receive certain treatments or medications at a lower cost.
Increased healthcare costs: Medicare confusion can also lead to increased healthcare costs, as beneficiaries may inadvertently choose plans or services that are not the most cost-effective for their needs. This can result in higher out-of-pocket expenses, premiums, and deductibles, which can be a financial burden for many seniors.
Frustration and stress: Finally, Medicare confusion can cause frustration and stress for beneficiaries, who may feel overwhelmed by the complexity of the program and the difficulty of navigating its rules and regulations. This can be particularly challenging for those who are already dealing with health issues or other stressors in their lives.
Medicare confusion can have serious consequences for beneficiaries, highlighting the need for clear and accessible information about healthcare coverage options and regulations.

Tips for Reducing Medicare Confusion

Fortunately, there are several strategies that Medicare beneficiaries can use to reduce confusion and make more informed decisions about their healthcare coverage. These include:
Understanding the basics of Medicare: One of the most important steps in reducing Medicare confusion is to have a clear understanding of the basics of the program. This includes knowing the different parts of Medicare, what they cover, and how to enroll. Resources like

Fair Square’s blog

can help you do your own research and learn about the different options available to you.
Seeking guidance from Fair Square’s team of Medicare experts: For those who want more personalized support, working with a team of Medicare experts can be a great way to navigate the complexities of the program. Fair Square has a team of knowledgeable and experienced experts who can help you research and compare plans, answer your questions, and guide you through enrollment.
Researching and comparing plans: Working with a

licensed Medicare advisor at Fair Square

can help you make sense of the different plans and options available. Call 888-376-2028 today for a free consultation. 
Asking questions and seeking clarification: If you have questions or are unsure about something related to your Medicare coverage, don't hesitate to ask for clarification. Fair Square's team of Medicare experts can help you understand the rules and regulations and guide you on how to make the most of your benefits. You can also reach out to your specific plan provider to ensure you get the most of your plan's unique benefits.
Keeping track of important dates and deadlines: Finally, it's essential to keep track of important dates and deadlines related to your Medicare coverage. This includes enrollment periods, plan changes, and deadlines for submitting claims or appeals. Staying organized and up-to-date can help you avoid confusion and ensure that you are getting the coverage you need.

Conclusion

We get it; Medicare can be very confusing. That's why I started this company, to give everyone the Medicare shopping experience that I wish my parents had. If you feel overwhelmed by all of it, you are not alone and have resources to fall back on. Fair Square is here to simplify Medicare and empower you to be your own best advocate. Call us today at 888-376-2028.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Recommended Articles

Senior woman smiling after vaccination stock photo
Does Medicare Cover Flu Shots?
Dec 9, 2022
Philadelphia skyline at sunset stock image
13 Best Ways for Seniors to Stay Active in Philadelphia
Mar 7, 2023
Diagnosis overactive bladder stock image
Does Medicare Cover PTNS?
Dec 9, 2022
Senior person holding tissue roll near a toilet bowl, using walker to walk to the bathroom stock photo
Does Medicare Cover Disposable Underwear?
Dec 8, 2022
Medicare Part A & Part B stock photo
How Much Does Medicare Part A Cost in 2023?
Nov 18, 2022
Senior couple working at a computer stock image
Do I Need Medicare If My Spouse Has Insurance?
Dec 19, 2022
Medigap and Medicare Advantage arrows stock image
Can I switch From Medicare Advantage to Medigap?
Sep 14, 2022
stack of books stock image
Do You Need Books on Medicare?
Apr 6, 2023
Fair Square
Is Displacement Affecting Your Medicare Coverage?
Oct 6, 2022
Union Station in Denver stock image
15 Best Ways for Seniors to Stay Active in Denver
Mar 9, 2023
scleral lenses
Does Medicare Cover Scleral Lenses?
Dec 5, 2022
Cover image
Does Medicare cover Hyoscyamine?
Nov 30, 2022
Medicare 2023 What you need to know in the new year stock image
How is Medicare Changing in 2023?
Dec 21, 2022
Dripping medication stock photo
Does Medicare Cover Ketamine Infusion for Depression?
Nov 23, 2022
doctor examining a patient's varicose veins stock photo
Does Medicare Pay for Varicose Vein Treatment?
Nov 18, 2022
Medicare cost stock image
How Much Does Medicare Cost?
Jul 25, 2022
Senior woman having vision problems stock photo
Does Medicare Cover Macular Degeneration?
Nov 30, 2022
Last will and testament stock photo
Does Medicare Pay for Funeral Expenses?
Dec 6, 2022

More of our articles

14 Best Ways to Stay Active in Charlotte

20 Questions to Ask Your Medicare Agent

Building the Future of Senior Healthcare

Can Doctors Choose Not to Accept Medicare?

Can I Change Medicare Advantage Plans Any Time? | Medicare Plans

Can I Have Two Primary Care Physicians?

Can I Laminate My Medicare Card?

Can Medicare Advantage Plans Deny Coverage for Pre-Existing Conditions?

Comparing All Medigap Plans | Chart Updated for 2023

Do I Need to Renew My Medicare?

Does Medicare Cover a Spinal Cord Stimulator?

Does Medicare Cover an FMT?

Does Medicare Cover Breast Implant Removal?

Does Medicare Cover Cataract Surgery?

Does Medicare Cover Cervical Disc Replacement?

Does Medicare Cover Chiropractic Visits?

Does Medicare Cover Compounded Medications?

Does Medicare Cover Geri Chairs?

Does Medicare Cover Hepatitis C Treatment?

Does Medicare Cover Home Heart Monitors?

Does Medicare Cover Incontinence Supplies?

Does Medicare Cover Inqovi?

Does Medicare Cover Inspire for Sleep Apnea?

Does Medicare Cover Kyphoplasty?

Does Medicare Cover Light Therapy for Psoriasis?

Does Medicare Cover LVAD Surgery?

Does Medicare Cover Mental Health?

Does Medicare Cover Orthodontic Care?

Does Medicare Cover Ozempic?

Does Medicare Cover Physicals & Blood Work?

Does Medicare Cover Piqray?

Does Medicare Cover Qutenza?

Does Medicare Cover RSV Vaccines?

Does Medicare Cover Service Animals?

Does Medicare Cover Shock Wave Therapy for Plantar Fasciitis?

Does Medicare Cover TENS Units?

Does Medicare Cover the WATCHMAN Procedure?

Does Medicare Cover Wart Removal?

Does Retiring at Age 62 Make Me Eligible for Medicare?

Does Your Plan Include A Free Gym Membership?

Explaining the Different Enrollment Periods for Medicare

Fair Square Bulletin: We're Revolutionizing Medicare

Fair Square Client Newsletter: AEP Edition

Finding the Best Dental Plans for Seniors

Health Savings Accounts (HSAs) and Medicare

How Are Medicare Star Ratings Determined?

How Do Medigap Premiums Vary?

How Does Medicare Pay for Emergency Room Visits?

How Much Does a Medicare Coach Cost?

How Often Can I Change Medicare Plans?

How to Apply for Medicare?

How to Enroll in Social Security

How Your Employer Insurance and Medicare Work Together

Is Balloon Sinuplasty Covered by Medicare?

Is Fair Square Medicare Legitimate?

Is the Shingles Vaccine Covered by Medicare?

Is Vitrectomy Surgery Covered by Medicare?

Medicare & Ozempic

Medicare Advantage MSA Plans

Medicare Explained

Medicare Savings Programs in Kansas

Plan G vs. Plan N

The Fair Square Bulletin: August 2023

The Fair Square Bulletin: February 2024

The Fair Square Bulletin: January 2024

The Fair Square Bulletin: November 2023

Welcome to Fair Square's First Newsletter

What Does Medicare Cover for Stroke Patients?

What is a Medicare Beneficiary Ombudsman?

What is the 8-Minute Rule on Medicare?

What is the Medicare ICEP?

Which Medigap Policies Provide Coverage for Long-Term Care?

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.
Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2025

Terms of Use
Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2025 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M