Medicare eligibility begins at 65 regardless of retirement date. Your initial enrollment period starts 3 months before your 65th birthday. You must choose between Original Medicare (Parts A+B) with optional Medigap supplement and Part D drug coverage, or Medicare Advantage (Part C) which bundles everything. IRMAA surcharges increase premiums for higher-income retirees. Coordination with your financial plan is essential.
Medicare Parts Explained
Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing, hospice, and some home health. Most people pay $0 in premiums if they paid Medicare taxes for 10+ years. Part B (Medical Insurance): Covers doctor visits, outpatient care, preventive services, and medical equipment. Standard 2026 premium is approximately $185/month, with IRMAA surcharges for incomes above $106,000 (single) or $212,000 (married). Part C (Medicare Advantage): Private insurance plans that bundle A, B, and usually D. May offer dental, vision, and hearing. Limited provider networks. Part D (Prescription Drug): Covers prescription medications. Offered through private insurers. Costs vary by plan and medications.
IRMAA: The Medicare Surcharge Most People Miss
If your modified adjusted gross income exceeds certain thresholds, you pay Income-Related Monthly Adjustment Amounts (IRMAA) on top of standard Part B and Part D premiums. IRMAA is based on income from two years prior. A large Roth conversion, capital gain, or pension payout can trigger surcharges that last for years. We coordinate Medicare planning with your overall tax and withdrawal strategy to minimize IRMAA exposure.
Approaching 65?
We coordinate your Medicare decisions with your overall retirement and tax strategy.
