Turning 65 is a major milestone—and for many, it comes with a new challenge: figuring out Medicare. If you’ve ever opened the Medicare & You handbook and felt more confused than when you started, you’re not alone. That’s exactly why we created this video and blog post—to simplify Medicare, break down the key decisions, and help you avoid costly mistakes.
Why We Made This Video
We’ve helped thousands of people navigate Medicare over the years, and the biggest issue we see is confusion. The system is complex. It’s full of rules, time-sensitive enrollment windows, and penalties if you don’t sign up correctly. Our goal is to take the 131-page government manual and condense it into something you can actually understand—and use.
Understanding the Parts of Medicare
Let’s start with the basics. Medicare has four parts:
- Part A – Hospital insurance
- Part B – Medical insurance (doctor visits, outpatient care)
- Part C – Medicare Advantage (a private alternative to Original Medicare)
- Part D – Prescription drug coverage
While it sounds like you might need to sign up for all four, that’s not always the case. In fact, many people stick with Original Medicare (Parts A & B), then add a Medicare Supplement (Medigap) policy and a standalone Part D drug plan.
One major source of confusion is Part C (Medicare Advantage). Despite the name, it’s not a supplement. In fact, when you sign up for a Part C plan, you’re actually leaving Original Medicare. Some Advantage plans offer dental or vision coverage, but they come with provider networks, referrals, and more restrictions—so it’s important to know what you’re giving up to get those extras.
What Medicare Doesn’t Cover
Original Medicare doesn’t cover everything. Here are some common services that are not included:
- Dental exams and most dental care
- Routine vision or eye exams (except for specific conditions like cataracts)
- Hearing aids
- Long-term care (custodial care)
- Massage therapy
- Cosmetic surgery
- Routine physical exams or concierge care
If you want coverage for these services, you’ll likely need separate insurance. Many of our clients carry dental, vision, or long-term care insurance in addition to Medicare.
When to Sign Up for Medicare
One of the biggest mistakes we see is signing up for Medicare too early—or too late. If you’re still working at 65 and covered under a group plan with 20 or more employees, you can usually delay signing up for Medicare without penalty. But if you’re on COBRA or your employer has fewer than 20 employees, you do need to sign up—otherwise, you could face lifetime penalties.
There’s a lot of misinformation out there, and friends or coworkers often give advice based on their own situations, which may not apply to you. That’s why it’s important to understand which “camp” you fall into—and work with someone who can help you sort it out.
What Is IRMAA—and Why Does It Matter?
If your income is above certain thresholds, you’ll pay more for Medicare through something called IRMAA (Income-Related Monthly Adjustment Amount). For 2025, standard Part B premiums start at $185/month, but IRMAA can increase that to more than $500/month. And it applies to Part D drug plans too.
The good news? If you’re retiring and your income drops, you may be able to appeal IRMAA. We help our clients with that process all the time.
Medicare Supplements: Plan G vs. Plan N
If you choose to stay on Original Medicare, you’ll want to look into a Medicare Supplement (Medigap) plan. These plans help cover the 20% that Medicare doesn’t pay. The most popular options are:
- Plan G – The most comprehensive currently available to new enrollees
- Plan N – Slightly lower premiums, with some copays and a few exclusions
- High-Deductible Plan G – A lower-cost option with a higher out-of-pocket limit
All Medigap plans are standardized, meaning the benefits are the same no matter which insurance company offers them. But prices vary widely. That’s why we shop around and compare rates to get you the best value.
Don’t Forget Part D Drug Coverage
Even if you’re not taking medications, you still need to sign up for a Part D drug plan when you first enroll in Medicare—unless you have other creditable coverage. Otherwise, you could be hit with penalties that last a lifetime.
Starting in 2025, there’s a new $2,000 out-of-pocket maximum for drug costs. That’s a big improvement and worth understanding how your plan works as you move through the year.
Bringing It All Together: Medicare & Financial Planning
Medicare isn’t just about healthcare—it connects directly to your retirement income, taxes, and long-term care planning. We often help clients coordinate Medicare decisions with:
Social Security (which pays your Medicare premiums)
Retirement income (which can push you into higher IRMAA brackets)
Tax planning (especially Roth conversions or income smoothing)
Long-term care (which Medicare does not cover)
At Cardinal Advisors, we take a comprehensive financial planning approach to Medicare. It’s not just about signing up—it’s about doing it in a way that protects your health, income, and peace of mind.
