Medicare
Navigate Medicare without the confusion
Medicare has four parts, multiple enrollment windows, and penalties for missing deadlines. Here is what you need to know before you turn 65.
Medicare is more complex than most people expect
Most people assume Medicare is automatic and free. It is neither. You must actively enroll, choose your coverage, and pay premiums — and if you miss enrollment windows, you may face permanent penalties. Higher-income retirees also pay IRMAA surcharges that can add thousands of dollars per year to their costs.
The four parts of Medicare
Each part covers different services with different costs and enrollment rules.
Hospital Insurance
Covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Most people pay no premium for Part A if they or their spouse worked and paid Medicare taxes for at least 10 years.
Medical Insurance
Covers doctor visits, outpatient care, preventive services, and durable medical equipment. Part B has a monthly premium that increases with income (IRMAA). The standard premium in 2024 is $174.70/month.
Medicare Advantage
An alternative to Original Medicare offered by private insurers. Bundles Parts A and B (and usually Part D) into one plan. May include extra benefits like dental and vision, but restricts you to a network.
Prescription Drug Coverage
Covers prescription drugs through private plans. Premiums, deductibles, and formularies vary by plan. Missing the enrollment window results in a permanent late-enrollment penalty added to your premium.
What to watch out for
IRMAA surcharges
If your income exceeds certain thresholds, you pay higher Part B and Part D premiums. In 2024, IRMAA kicks in at $103,000 for individuals and $206,000 for couples. Proactive income planning can help you stay below these thresholds.
Enrollment windows
Your Initial Enrollment Period is the 7-month window around your 65th birthday. Missing it triggers late-enrollment penalties that last for life. Special enrollment periods apply if you have employer coverage.
Medigap / Supplement plans
Original Medicare has significant cost-sharing gaps. A Medigap (Medicare Supplement) policy fills those gaps, providing more predictable out-of-pocket costs. Enrollment timing affects your ability to get coverage without medical underwriting.
Common questions
Make sure your Medicare coverage is right for you
We help pre-retirees understand their Medicare options and coordinate coverage with their overall retirement income plan.
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