Written by Hazel Secco, CFP®, CDFA®
Medicare is available to most U.S. citizens and legal residents starting at age 65, provided they have worked and paid U.S. taxes for a sufficient period, or are or were married to someone who has. While Medicare opens the door to essential healthcare coverage in retirement, there are important decisions to make to ensure it fits your personal and financial situation.
Medicare Overview
Medicare is the largest health insurance program in the United States and generally becomes available at age 65 if you qualify for Social Security or Railroad Retirement Board benefits, or if you paid Medicare taxes while working in certain government roles.
There are several parts in Medicare coverage.
Original Medicare (Parts A & B)
Part A (Hospital Insurance)
Part A helps cover inpatient hospital stays, skilled nursing facility care (following a hospital stay), hospice care, and some home healthcare services. For most people, Part A is premium-free because they or their spouse paid Medicare taxes during their working years.
Part B (Medical Insurance)
Part B covers outpatient care such as doctor visits, preventive services, medical equipment, and diagnostic tests. Enrollment is time-sensitive—if you delay signing up for Part B without having creditable employer coverage, you may face permanent late-enrollment penalties.
The standard Part B premium for 2025 is $185 per month, with higher premiums applying to higher-income individuals.
Even with Original Medicare, you should expect out-of-pocket costs, including deductibles and coinsurance. Original Medicare does not cover prescription drugs, routine dental care, vision, or hearing services.
Additional Coverage Options
To help manage costs not covered by Original Medicare, retirees often consider the following:
Medicare Supplement Insurance (Medigap)
Medigap policies are sold by private insurers and help cover deductibles, copayments, and coinsurance under Original Medicare. Premiums vary by plan, provider, and location.
Medicare Part D (Prescription Drug Coverage)
Part D is optional prescription drug insurance offered by private insurers. Enrollment at age 65 is important—late enrollment without creditable coverage may result in penalties.
Beginning in 2025, Medicare Part D plans include a $2,000 annual out-of-pocket cap on covered prescription drug costs, a significant improvement for retirees managing ongoing medication expenses.
Medicare Advantage (Part C)
Medicare Advantage plans are offered by private insurance companies. They bundle Original Medicare with additional benefits. Also, they often include prescription drug coverage and services like dental, vision, and hearing care. These plans may have provider networks and referral requirements, which can limit flexibility compared to Original Medicare.
Working Past Age 65 or Employer Coverage
If you continue working past age 65 and are covered by an employer-sponsored health plan (either your own or your spouse’s), you may be able to delay enrolling in certain parts of Medicare without penalty. Once employer coverage ends, you’ll have a special enrollment period to sign up for Medicare.
Planning Ahead Matters
Healthcare costs remain one of the biggest and most unpredictable expenses in retirement—especially for women, who tend to live longer and may face higher lifetime healthcare suggests.
If you’re unsure how Medicare fits into your broader retirement plan, we’re here to help. We guide women through these decisions with clarity and confidence, so you can make informed choices and feel prepared for this important phase of life.
Ready to feel more confident about your retirement healthcare decisions?
Medicare and healthcare planning don’t have to feel overwhelming. If you’d like support creating a plan that fits your life, values, and long-term goals, we’re here to help.
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