The enrollment windows, the IRMAA traps, and the biggest uninsured risk in retirement.
The enrollment windows, the IRMAA traps, and the biggest uninsured risk in retirement.
Medicare has four parts. Part A covers hospitals (premium-free for most). Part B covers doctors and outpatient care ($202.90/month standard premium in 2026). Part C is Medicare Advantage, a private alternative to Original Medicare. Part D is prescription drugs. Original Medicare + Part D + Medigap is one path; Medicare Advantage is the other. They're different products with different tradeoffs.
Your Initial Enrollment Period is a 7-month window around your 65th birthday. Missing it can trigger lifelong late-enrollment penalties of 10%/year on Part B and 1%/month on Part D. If you're still working with employer coverage, you may be able to delay — but the rules vary by employer size, and getting it wrong is expensive.
Higher-income retirees pay IRMAA surcharges on Part B and Part D premiums. For 2026 premiums, those surcharges begin above $218,000 MAGI for couples filing jointly. The cliff is harsh — crossing by $1 can cost $1,000+/year per spouse. IRMAA uses income from 2 years prior, so Roth conversions at 63 can trigger surcharges at 65.
The biggest healthcare misconception in retirement: Medicare does not cover long-term care. 70% of people turning 65 will need some form of LTC. The average nursing home costs $100,000+/year. Your options are LTC insurance (expensive but certain), hybrid policies (better fit for most), self-insuring (requires 7-figure assets), or Medicaid (after spending down).
Once you choose Medicare Advantage and your initial 12-month trial window expires, switching back to Original Medicare + Medigap may require medical underwriting — and insurers can deny you. Healthy people have choices; sick people often don't.
Take the free Retirement Readiness Score to see where your plan stands across income, taxes, healthcare, and protection. Then talk to a fiduciary if you want help. No pitch, no pressure.
Take the free assessment