Pure’s Financial Advisor, Marysol Flores, CFP®, APMA®, breaks down four things that catch people off guard about Medicare.
Transcript
Medicare isn’t free — and the sticker price is only part of the story. Today we’re breaking down four things that catch people off guard: premiums, penalties, Part D, and the coverage decisions that shape what you’ll actually pay.
First up is premiums. Most people know about the Part B premium, but fewer realize it can increase based on income. If your income is above certain thresholds, you’ll pay more through something called IRMAA — the Income-Related Monthly Adjustment Amount. That number is based on your tax return from two years prior, so a high-income year can follow you into retirement.1
Next up is penalties. Here’s where things get expensive fast. If you don’t sign up for Part B or Part D when you’re first eligible — and you don’t have qualifying coverage elsewhere — you can face a permanent late enrollment penalty. Permanent. Not a one-time fee. It gets added to your premium for as long as you have Medicare, which is exactly why timing your enrollment matters.2
Now let’s dive into part D. Prescription drug coverage has its own quirks. Every Part D plan has a formulary — a list of covered drugs — and those lists change every year. A plan that covers your medications perfectly this year might not next year. It’s worth reviewing your plan annually, especially if you’re on maintenance medications.
Finally, we have coverage decisions with the big fork in the road: Original Medicare plus a supplement, or Medicare Advantage. One tends to offer more flexibility with providers; the other often comes with lower upfront costs but a narrower network. Neither is universally “better” — it depends on your health needs, your travel habits, and your budget.
The real cost of Medicare isn’t just the premium on paper — it’s the penalties you can avoid, the drug coverage you actually need, and the plan structure that fits your life. If you want to learn more about your options, how to choose coverage, and more information about the costs, premiums, and planning strategies of Medicare, download our free guide.
And if you’re approaching this decision in the near future, it’s worth talking it through. Have a no-cost, obligation-free conversation with Pure Financial today by scheduling a free financial assessment and get all your questions answered before you enroll, not after.
Sources:
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“Medicare Premiums 2026: IRMAA Brackets and Surcharges for Parts B and D.” May 7, 2026.
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Medicare.gov. “Avoid late enrollment penalties.” [Accessed August 21, 2026].
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APMA® – The Accredited Portfolio Management Advisor℠ or APMA® Program is a professional designation program for financial professionals. The program is designed to educate advisors on portfolio creation, augmentation, and maintenance. Topics covered include client assessment and suitability, risk/return, investment objectives, bond and equity portfolios, modern portfolio theory, investor psychology, and other topics germane to building appropriate client portfolios. Students gain hands-on practice in analyzing investment policy statements, building portfolios, and making asset allocation decisions, to include determining sell, hold, and buy decisions within a client’s portfolio. Individuals must take a two-part self-study course and pass an exam, to maintain this designation, individuals must complete 16 hours of continuing education every 2 years.
