Author: Cindy Corsini

Medicare surcharges can sneak up on more people than you might think—about 8% of beneficiaries now pay these extra premiums. For single retirees, staying at $109,000 in income keeps you at the standard premium. But just one extra dollar—$109,001—triggers the full annual surcharge, which can add up to $1,100. Couples face a similar challenge: if your combined income crosses $218,000 by even $1, both spouses see these surcharges. It’s not just high earners anymore; with thresholds frozen for years while costs rise, roughly 1 in 12 Medicare recipients are now affected. Regular income sources like RMDs, pensions, retirement benefits, and even tax-exempt interest can push you into higher premium territory.

Lawmakers have discussed raising the surcharge tiers and shielding home sale gains, but because these surcharges bring billions to Medicare, changes haven’t been easy to pass. That’s why careful planning matters. Precision Roth conversions before age 73, direct charitable transfers up to $111,000, and timely appeals after big life changes are all key strategies to manage your costs.

As someone who works one-on-one with clients to clarify Medicare and supplemental options, I know how overwhelming these numbers can be. My goal is always to help you understand your choices and feel confident about your coverage, so you’re protected from surprises like these surcharges.

When it comes to preparing for retirement, many people are surprised by the real cost of health care—even with Medicare in place. A recent planning estimate found that a 65-year-old retiring in 2026 could face an average of $185,500 in retirement health care expenses. That’s because medical costs often go well beyond what Medicare covers. In my work as a licensed independent insurance agent, I’ve seen how easy it is to assume Medicare will take care of everything, but research shows more than half of pre-retirees overestimate those benefits—especially as premiums continue to rise faster than retirement benefit increases.

It’s important to remember that Original Medicare doesn’t cover routine dental or vision exams for glasses, hearing aids, or long-term custodial care. These are major needs that require careful planning. Even with covered services, there are still out-of-pocket costs: in 2026, Part B alone is projected at about $203 a month, plus a deductible, 20% coinsurance, and possible surcharges if your income is above certain thresholds.

My approach is always to help you get ahead of these surprises. Reviewing Medicare’s gaps early, considering Medigap options during your one-time enrollment window, and using health savings accounts to build up reserves before you’re eligible can make all the difference in feeling secure about your choices. I believe that understanding your options—not just for Medicare, but also for dental, vision, and supplemental coverage—puts you in control of your retirement health and peace of mind.

It’s easy to assume Medicare will take care of all your health costs in retirement, but the reality is more complex. For someone retiring at 65 in 2026, average health care expenses are estimated at $185,500—far beyond what Medicare alone covers. I often hear from people who are surprised to learn that Original Medicare doesn’t include routine dental, vision exams for glasses, hearing aids, or long-term custodial care. Even with covered services, there are still out-of-pocket costs: for example, in 2026, the Part B premium is projected to be about $203 a month, plus a deductible and around 20% coinsurance. Higher incomes may also mean added surcharges.

If you’re approaching retirement, it’s important to review these gaps early. Take time to compare Medigap options during your one-time enrollment window, and consider using a health savings account to build up extra reserves before you become eligible. My approach is always to make these choices clear and manageable, so you can feel confident your coverage fits your real needs, not just what’s expected.

One of the biggest concerns I hear from clients approaching Medicare is managing those monthly bills—especially before Social Security deposits kick in. For 2026, a standard-premium couple will need to budget $405.80 per month for Part B ($202.90 each), and it’s important to have a reliable plan in place so these payments don’t become a source of stress.

Some folks have found peace of mind by pairing a three-ETF sleeve that focuses on dividend growth, steady monthly distributions, and ultra-short Treasury bills. This strategy can help cover recurring premiums without the need to sell off investments during market downturns. For example, annual dividends from a high-yield equity fund could fully cover a year’s worth of premiums with around 250 shares, while a monthly income fund could take care of those bills with about 750 shares. Meanwhile, a Treasury-bill fund acts as a safety net, allowing couples to set aside 6–12 months of premiums so they aren’t forced to dip into equity funds if the market takes a dip.

Even with a projected 3% adjustment coming to Social Security in 2027, it’s wise to have a predictable, steady income stream to handle Medicare costs in the meantime. I always encourage thoughtful, proactive planning—because taking the confusion out of Medicare is what I’m here for.

GLP-1 medications have become a frequent topic of conversation, especially for those managing diabetes or exploring options for weight management. As a Licensed Independent Insurance Agent focused on Medicare and supplemental coverage, I hear a lot of questions about how these drugs are covered under different health plans. In the US, most plans do cover GLP-1 medications when prescribed for diabetes or related conditions, but coverage for weight-loss-only use is far less common. The specifics can really depend on your plan—some require prior authorization or a minimum BMI, and coverage can vary between individual and employer-sponsored plans. For example, individual market plans rarely include weight-loss prescriptions, while about 60% of employer plans cover diabetes treatment and around 35% cover both diabetes and weight loss. Medicare, the federal senior health program, still does not cover weight-loss-only use, though a pilot program is offering certain GLP-1 medications for $50 per month. State-federal programs have their own unique rules as well. If you’re exploring these medications, it’s important to review your plan’s details, understand the requirements, and keep an eye on possible changes. My role is to help make sense of these options so you can feel confident in your health decisions.

Retirement planning isn’t just about how much you’ve saved—it’s about how and when you access those funds, especially when it comes to your Medicare costs. I see this firsthand working with clients transitioning to Medicare: two people can have the same $2.1M nest egg, but end up with very different tax bills and premiums depending on their withdrawal strategies.

For example, a portfolio split between taxable savings and a traditional IRA might generate $117,400 a year, but where those assets are held impacts both your current efficiency and future tax pressure. For 2026, joint filers with a MAGI at or below $218,000 keep standard Medicare premiums—go just one dollar over, and Part B jumps by nearly $284, plus additional Part D surcharges.

If you drain taxable accounts first, your IRA could grow and lead to larger required minimum distributions (RMDs) later on, which may increase your Medicare costs. On the other hand, planning IRA withdrawals or conversions before RMD age can help reduce future pressure.

My approach is to help you model these paths before year-end, keeping any conversions below the next IRMAA threshold, and reviewing your IRA holdings for any floating-rate, leverage, or concentration risks. It’s about making Medicare decisions with clarity and confidence—one step at a time.