Medicare Made Simple: A Guide for Soon-to-be-Retirees
If you’re nearing retirement age, you’ve probably started hearing a lot about Medicare—but how does it actually work, and what do you really need to know? This guide breaks down the basics of Medicare in plain English: when to enroll, what each part covers, and how to avoid costly mistakes. If Medicare feels confusing or overwhelming (you’re not alone!), this is the place to start.
Medicare Made Simple: A Guide for Soon-to-be-Retirees
If you’re closing in on retirement, you’ve probably gotten mailers, emails, and maybe even a few unsolicited phone calls about Medicare. And if your first reaction is, “I know I need to figure this out, but I have no idea where to start”—you’re in good company.
Medicare is an important piece of your retirement plan. But let’s be honest: the government didn’t exactly make it easy to understand.
This guide is here to help you cut through the noise. We’ll cover the basics of what Medicare is, when and how to enroll, and common mistakes to avoid—so you can make smart decisions and feel confident about your coverage.
First Things First: What Is Medicare?
Medicare is a federal health insurance program primarily for people age 65 and older. It helps cover many healthcare costs that could otherwise drain your savings in retirement.
There are four “parts” of Medicare, and here’s the simplest way to think about them: Part What It Covers
Part A Hospital insurance (inpatient care, skilled nursing, hospice)
Part B Medical insurance (doctor visits, outpatient care, preventive services)
Part C Medicare Advantage (private plans that bundle A & B, often with extras like dental/vision)
Part D Prescription drug coverage. Think of Parts A and B as “Original Medicare,” and Parts C and D as optional ways to customize your coverage.
When Should You Sign Up for Medicare?
Your Initial Enrollment Period (IEP) is a 7-month window:
• Starts 3 months before the month you turn 65
• Includes your birthday month
• Ends 3 months after your birthday month
✅If you’re already collecting Social Security before 65, you’ll be automatically enrolled in Parts A and B.
🚩If you’re not collecting Social Security yet, you’ll need to actively sign up.
What If You’re Still Working at 65?
This is one of the biggest questions for people who aren’t quite ready to retire at 65.
• If you’re still working and your employer provides credible health coverage (and the company has 20+ employees), you may not need to sign up for Part B yet.
• You can delay Part B without penalty and enroll later during a Special Enrollment Period (SEP) when your work coverage ends.
But Part A is still worth signing up for at 65 in most cases—it’s premium-free if you or your spouse worked and paid Medicare taxes for at least 10 years.
What Does Medicare Cost?
Here’s a simple breakdown of what you can expect:
Coverage Monthly Premium (2025 estimates)
Part A $0 (if you or spouse worked 10+ years)
Part B $185 (higher if your income is above certain thresholds)
Coverage Monthly Premium (2025 estimates)
Part C (Advantage Plan) Varies by plan
Part D (Drug Plan) Varies by plan
Medigap (Supplement) Varies by plan and location
💡Part B and Part D premiums may be higher if your income is above $106,000 (single) or $212,000 (married filing jointly), due to something called IRMAA (Income-Related Monthly Adjustment Amount).
Do You Need a Medicare Supplement (Medigap) or Medicare Advantage?
Once you have Original Medicare (Parts A and B), you’ll have two basic paths to choose from:
Option 1: Original Medicare + Medigap + Part D
• Freedom to see any doctor who accepts Medicare.
• Buy a separate Medigap (Supplement) plan to help cover out-of-pocket costs like deductibles and copays.
• Add Part D for prescription drug coverage.
• Higher monthly premium, but fewer unexpected out-of-pocket costs.
Option 2: Medicare Advantage (Part C)
• All-in-one plan that includes Parts A, B, and often D.
• Lower premiums, but may have network restrictions (like HMOs or PPOs). • Often includes extras like dental, vision, or hearing benefits.
• You may have more out-of-pocket costs if you need care outside the network.
🚩 Important: You generally can’t have both a Medicare Advantage plan and a Medigap plan at the same time. It’s one or the other.
Common Medicare Mistakes to Avoid
1. Missing your enrollment window
Late enrollment in Part B or Part D can lead to permanent penalties.
2. Assuming Medicare covers everything
Medicare does not cover:
o Long-term care (like assisted living)
o Most dental, vision, or hearing care (unless you choose an Advantage plan with these extras)
3. Not comparing drug plans
Prescription coverage (Part D) plans can vary widely in what they cover and how much they charge.
4. Overlooking IRMAA if your income is high
If you’ve recently retired and your income has dropped, you may be able to appeal IRMAA charges.
Who Can Help You Choose the Right Medicare Coverage?
One of the reasons Medicare feels so overwhelming is because there are a lot of moving parts—and many choices to make.
The good news? You don’t have to figure it out alone.
Here are some of the professionals who can help guide you through the process:
✅ Licensed Medicare Insurance Agents or Brokers
These are professionals who specialize in Medicare plans and can help you compare
your options. Some work with just one insurance company, while others (called brokers) can show you plans from multiple companies.
How they help:
• Explain the differences between Medicare Advantage, Medigap, and Part D plans • Help you compare premiums, out-of-pocket costs, and coverage options • Assist with the enrollment process
What to know:
• A good agent will take the time to understand your health needs—not just sell you a plan.
• Their services are typically free to you (they’re paid by the insurance companies).
✅ Financial Advisors (like us!)
While financial advisors aren’t licensed to sell Medicare insurance, many (including our team at Intermountain Wealth Management) help clients understand how Medicare fits into the bigger retirement picture.
How we help:
• Coordinate your Medicare choices with your retirement income plan
• Estimate how healthcare costs (including premiums and out-of-pocket expenses) will impact your cash flow
• Help you avoid costly mistakes like missing enrollment deadlines or choosing coverage that doesn’t align with your financial plan
• Connect you with trusted Medicare specialists when needed
How Medicare Fits Into Your Retirement Plan
Medicare is a key piece of your overall retirement puzzle—but it’s not one-size-fits-all. Your health needs, your budget, and whether you’re still working all play a role in choosing the right coverage.
Here’s what we often help clients think through:
• How does Medicare fit alongside your other healthcare expenses (like long-term care insurance)?
• How will premiums and out-of-pocket costs affect your retirement cash flow?
• Should you choose Original Medicare with a Supplement, or would Medicare Advantage better fit your lifestyle?
Having a plan helps you avoid surprises—and gives you peace of mind that your healthcare is covered as you step into retirement.
Ready to Make Sense of Medicare?
If Medicare feels like alphabet soup right now, you’re not alone. But the good news is—you don’t have to figure it out on your own.
At Intermountain Wealth Management, we help clients navigate these decisions every day. If you’re approaching retirement (or already there) and want a clear plan for how Medicare fits into the bigger picture of your financial life, we’re here to help.
Reach out anytime—we’d love to help you feel confident about what’s next.
Intermountain Wealth Management is a Registered Investment Adviser (RIA). The company manages several fee-based portfolios comprised of various equity and fixed-income investments that may include mutual funds and exchange traded funds. This is not a prospectus or an offer to sell any security. Please read the prospectus of any investment before you invest. Information included here is intended for education and information purposes only.
