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Retirement Planning

Medicare Planning

Understanding Medicare's complex enrollment rules, income-based surcharges, and coordination with other coverage is essential for avoiding costly penalties and maximizing healthcare benefits in retirement.

Medicare Planning

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Medicare Parts A-D Overview

  • Part A: Hospital insurance, usually premium-free with 40+ work quarters
  • Part B: Medical insurance covering doctors and outpatient care, $185/month in 2025
  • Part C: Medicare Advantage, private plans combining A+B, often includes Part D
  • Part D: Prescription drug coverage, average premium $55/month, penalty for delays

Full Guide

Medicare Parts A-D Overview

  • Part A: Hospital insurance, usually premium-free with 40+ work quarters
  • Part B: Medical insurance covering doctors and outpatient care, $185/month in 2025
  • Part C: Medicare Advantage, private plans combining A+B, often includes Part D
  • Part D: Prescription drug coverage, average premium $55/month, penalty for delays

Enrollment Periods and Penalties

  • Initial Enrollment: 7-month window around 65th birthday (3 months before and after)
  • General Enrollment: January through March annually, coverage starts July
  • Special Enrollment: Qualifying events like losing employer coverage extend deadlines
  • Part B penalty: 10% per 12-month delay period, permanent lifetime surcharge

Medigap vs Medicare Advantage

  • Medigap supplements Original Medicare with standardized plans A through N
  • Medicare Advantage replaces Original Medicare but has network limitations
  • Cannot have both Medigap and Medicare Advantage simultaneously
  • Medigap guaranteed issue during 6-month window after Part B enrollment

IRMAA Income Surcharges

  • High earners pay additional Part B and D premiums based on income from two years prior
  • Individual MAGI thresholds start at $106,000 with multiple tiers through $500,000+
  • Married filing jointly thresholds are double individual thresholds for most brackets
  • Part B surcharges range from $69.90 to $419.30 monthly in 2025

Employer Coverage and HSA Coordination

  • With 20+ employees, employer plan pays first and Medicare is secondary
  • COBRA does not count as creditable coverage for Medicare enrollment purposes
  • Cannot contribute to an HSA once enrolled in any part of Medicare
  • Existing HSA funds remain available for qualified medical expenses tax-free
  • Plan HSA contribution timing carefully around Medicare enrollment decisions

Annual Open Enrollment

  • Medicare Open Enrollment: October 15 through December 7, changes start January 1
  • Review plan formularies, networks, and costs annually for optimal coverage
  • Medicare Advantage Open Enrollment: January 1 through March 31 for plan switches
  • Document health changes and new medications when evaluating plan options

Key Planning Considerations

  • Enroll in Medicare on time to avoid permanent penalties and coverage gaps
  • Review income projections for IRMAA implications two years in advance
  • Coordinate employer coverage transitions carefully with Medicare enrollment timing
  • Stop HSA contributions before Medicare enrollment to avoid tax penalties