Norma McKinney is a Northwest educational speaker on Medicare and qualified insurance broker helping individuals make informed decisions about medicare insurance plans.

I help people planning their health care coverage, usually for their life after 65. Just like advance care planning, it’s often fraught with confusion and misunderstanding. But unlike advance care planning, it’s not easy to change your mind, your form, or your coverage.

Medicare knowledge in an important element for the golden years and, ultimately, end of life preparation: Medicare decisions could impact the financial feasibility of preferred medical choices, whether those wishes can be completed as envisioned .  So, let me explain a cornerstone in ensuring the right Medicare fit.

Medicare has two parts: Part A & Part B.

You receive Medicare Part A automatically after working 40 quarters, turning 65 and paying into Medicare through a payroll tax deduction on every paycheck.  Medicare Part A provides hospitalization coverage.

Medicare Part B provides coverage for all your medical providers. Medicare Part B is not automatic; you must enroll.   The standard Part B premium is $148.50.  However, Social Security will add an additional amount Part B and Part D monthly premium for some.  This Income Related Monthly Adjustment Amount (IRMMA) might impact you; so it is important to know how this all works together

IRMAA determines your Medicare Part B monthly premiums also based on two years of tax returns. Essentially what IRMAA does is this:  the higher your reported income the more Medicare Part B and Part D monthly premium you will pay.

Sometimes a visual can help. The following table outlines the monthly premiums.

Depending on income, there could be additional Part B monthly premium and additional Part D monthly premium. Which, in the end, could impact your overall finances and healthcare planning.

You are right: it is confusing! And it’s also a critical aspect for some many retirees. I’m always here to help if you have questions. Please reach out to or call (425)269-6239.