Overlooking key details can lead to unexpected costs and limited healthcare options.
1) Income-Related Monthly Adjustment Amount (IRMAA) Surcharges – (Higher Costs for Higher Earners)
- Many high-income retirees are caught off guard by IRMAA surcharges on Medicare Part B and Part D premiums.
- Medicare premiums are based on your modified adjusted gross income (MAGI) from two years ago, meaning a high-earner retiring at 65 could be paying much more than expected.
- There are ways to reduce or appeal IRMAA, such as filing for a “life-changing event” if income drops in retirement, but many don’t plan for this in advance.
From our 2025 Key Financial Numbers flyer
2) Medicare Doesn’t Cover Long-Term Care or Concierge Medicine
- Many pre-retirees assume Medicare will cover assisted living or private in-home care—it doesn’t.
- Traditional long-term care or a hybrid long-term care policy (which blends life insurance with LTC benefits) could be a good strategy.
- Additionally, if you use a concierge doctor, check whether they accept Medicare or require direct payment. Some top-tier medical practices don’t participate in Medicare at all.
3) Choosing the Right Coverage: Medicare Advantage vs. Original Medicare + Supplements
- Many retirees initially choose Medicare Advantage for lower upfront costs but later regret network restrictions when they want to see top specialists nationwide.
- Original Medicare + Medigap (Supplement Plan G or N) + Part D is usually a better choice for high-net-worth individuals who want access to the best doctors without referrals.
- The biggest mistake? Waiting too long to get a Medigap plan. You only have six months after enrolling in Part B to get a policy without medical underwriting. After that, pre-existing conditions could make getting good coverage more expensive or impossible.
Avoiding these Medicare missteps can help retirees protect their health, finances, and freedom of choice—because the right plan isn’t just about coverage, it’s about confidence in your retirement years.
A TVAMP advisor can walk you through your Medicare decision.
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