Claudine Mesnil
Director of OperationsClaudine holds a Florida Life & Health license and works with clients in English, Spanish and French.
Read full bio →Medicare, IRMAA & healthcare costs
Plan for healthcare costs before they plan for you
We help you understand Medicare timing, IRMAA surcharges and healthcare costs, so they fit into your retirement income and tax plan.
Is this you?
If any of these sound familiar, this page is for you.
- You're turning 65 soon and aren't sure what to do, or when.
- Your Medicare premiums went up and the letter mentioned IRMAA.
- You plan to retire before 65 and need to cover health insurance until Medicare starts.
- You're thinking about a Roth conversion and want to know how it may affect your premiums.
- You want a realistic number for healthcare in your retirement budget.
What we look at
What a medicare & irmaa review covers
Your enrollment timeline
When your Medicare enrollment window opens and closes, and how it fits with when you stop working.
Your income, two years back
IRMAA is based on income from two years earlier. We look at what your tax returns may mean for future premiums.
Withdrawal order and timing
Which accounts you draw from, and when, can change your reported income. We look at how that may affect IRMAA.
Roth conversion timing
A conversion adds to your income in the year you do it. We look at how timing may affect your premiums later.
The bridge to 65
If you retire early, we look at how health insurance costs before Medicare fit into your income plan.
The long-term care gap
Medicare generally doesn't cover custodial long-term care. We look at whether that risk is part of your plan.
Medicare basics
Your Medicare timeline starts at 65
Your Initial Enrollment Period is seven months long. It starts three months before the month you turn 65, includes your birthday month, and ends three months after.
Missing your window can mean late enrollment penalties in some cases. Whether you're still working, covered by a spouse's plan or retiring early can change what makes sense for you. We help you map the dates so nothing sneaks up on you.
- 3 months before your 65th birthday month: your window opens
- Your birthday month: still inside the window
- 3 months after: your Initial Enrollment Period ends
IRMAA explained
Higher income can mean higher Medicare premiums
IRMAA stands for Income-Related Monthly Adjustment Amount. It's an extra charge added to Medicare Part B and Part D premiums when your income is above certain levels.
Medicare uses your income from two years earlier to set it. So a large IRA withdrawal, a Roth conversion or the sale of a property can show up in your premiums two years later. The income brackets and surcharge amounts change every year, so check the current year's figures from Medicare or the Social Security Administration.
Planning levers
Ways planning may help manage IRMAA
There's no single fix, and results vary. But the order and timing of your income can make a difference. We look at your full picture and coordinate with your tax professional.
- Withdrawal order: which accounts you draw from first, and how much each year
- Roth conversion timing: spreading conversions out, or doing them before the two-year look-back reaches your Medicare years
- Watching one-time income: planning around property sales and other large events where you can
- Life-changing events: understanding when an IRMAA appeal may be possible after retirement or another qualifying change
Bridging to 65
Retiring before Medicare starts
If you stop working before 65, you'll need health coverage until Medicare begins. Options may include retiree coverage from your employer, COBRA, a spouse's plan or a marketplace plan.
Each option has a cost, and some depend on your income. We help you build those costs into your retirement income plan so the gap years are covered. Because Medicare generally doesn't pay for custodial long-term care, we also talk about whether a long-term care plan belongs in the picture.
The tool
Book a healthcare-cost and IRMAA review
Bring your recent tax returns and your retirement date. We'll walk through your Medicare timeline, how your income may affect IRMAA, and what healthcare may cost in your plan. This is education and planning, not a plan sale.
Book a healthcare-cost review
15 minutes to start, at Trafalgar Plaza or by video. We’ll cover:
- Your enrollment timeline
- Your income, two years back
- Withdrawal order and timing
- Roth conversion timing
Who you’ll talk to
The licensed insurance agents for medicare & irmaa
Henrique Thormann
Licensed Insurance AgentHenrique focuses on long-term care preparation, which connects directly to what Medicare does and doesn't cover.
Read full bio →Karey Hensley Rebello, CPA, CFP®
Insurance Sales & Tax PlanningKarey is a CPA and CFP® professional focused on tax planning, which is where IRMAA starts: your reported income.
Read full bio →John Petrucco
Licensed Insurance AgentJohn has 30 years of experience simplifying complex financial decisions, including how retirement income choices affect your healthcare costs.
Read full bio →
As heard on Let’s Talk Safe Money®
Hear Len and Art explain it on the show.
Len and Art host the show on 610 WIOD. Watch more episodes in LSF University.
Watch full episodesQuestions
Common questions about medicare & irmaa
What is IRMAA, and who pays it?
IRMAA is the Income-Related Monthly Adjustment Amount. It's an extra charge on Medicare Part B and Part D premiums for people whose income is above set thresholds. Most people don't pay it, but higher-income retirees, and people with a one-time spike in income, may. The thresholds change each year, so check the current year's figures.
Which year's income is used to set my Medicare premiums?
Medicare generally uses your tax return from two years earlier. For example, the income you report in one year may affect your premiums two years later. That's why planning a few years ahead can matter.
Can I appeal IRMAA after a life-changing event like retirement?
In many cases, yes. If your income dropped because of a qualifying life-changing event, such as stopping work, you can ask the Social Security Administration to use more recent income. Approval depends on your situation and the documentation you provide. We can help you understand the process.
How can Roth conversions or withdrawal timing affect IRMAA?
A Roth conversion counts as income in the year you do it, and so do withdrawals from traditional IRAs and 401(k)s. That income may raise your premiums two years later. Timing and spreading out conversions or withdrawals may help manage the impact, though results vary and it's not tax advice for your situation.
How much should I plan for healthcare in retirement?
It depends on your health, your coverage choices, your income and how long you live. Premiums, deductibles and out-of-pocket costs change every year, so we use current figures for your situation rather than a one-size-fits-all number. The goal is a realistic line item in your income plan.
Does Medicare cover long-term care?
Generally not. Medicare may cover limited skilled nursing or home health care after a qualifying hospital stay, but it generally doesn't pay for custodial care, like help with bathing or dressing over the long term. That's why long-term care planning is its own conversation.
Serving Broward, Palm Beach, Miami-Dade & North Carolina
Call 954.999.0355Trafalgar Plaza, 5310 NW 33rd Ave., Suite 114, Fort Lauderdale, FL 33309 · In person, or by video from anywhere in the country
Connect with a licensed insurance agent
Book a healthcare-cost review
15 minutes, no obligation. Pick a time and we’ll call you, or meet us at Trafalgar Plaza or by video.
- Topic set to Healthcare costs & IRMAA, change it if you like.
- Prefer to call? 954.999.0355
Important information. This page is for educational purposes only. LSF Capital does not sell Medicare Supplement, Medicare Advantage or Part D plans through this page and is not affiliated with or endorsed by Medicare, the Centers for Medicare & Medicaid Services (CMS), the Social Security Administration or any government agency. Medicare rules, premiums and IRMAA thresholds change annually; check current figures at Medicare.gov or SSA.gov. This is not tax or legal advice for your situation; consult your tax professional. LSF Capital serves Broward, Palm Beach and Miami-Dade from Trafalgar Plaza, 5310 NW 33rd Ave., Suite 114, Fort Lauderdale, FL 33309, in person or by video.