Medicare guide
Look beyond the monthly premium.
Understand the different Medicare costs so you can compare coverage on more than a single number.
Read the transcript
Still working at 65? Don't guess this one. Hi, I'm Julianne Dickey, We Care Medicare, your Medicare insurance broker for the Central Coast.
Some employer plans stay first in line when you go on Medicare. Others make Medicare step up. Company size matters, COBRA matters, and health savings accounts definitely matter.
Get this wrong and your penalties or coverage gaps can follow you for the rest of your life. One conversation now can save you years of headache, so call before anything changes. Let's make Medicare make sense together.
Know the terms
Different costs. One yearly budget.
- Premium
- The amount you pay to keep coverage.
- Deductible
- The amount you may pay before certain benefits begin.
- Copayment
- A set amount for a covered service.
- Coinsurance
- Your share of a covered cost.
Compare these together. Coverage limits, income adjustments and enrollment penalties are separate questions explained below.
Know which cost you are comparing
A premium is the amount you pay to keep coverage. A deductible is the amount you may need to pay before certain benefits begin. Copayments are set amounts for covered services; coinsurance is a share of the cost.
Original Medicare does not have an automatic annual out-of-pocket maximum. Medicare Advantage has a medical out-of-pocket limit. Part D has a separate limit for covered prescription drugs.
A starting point for 2026 costs
The standard Part B premium in 2026 is $202.90 per month and the annual Part B deductible is $283. Your premium can be higher based on income. Many people pay no Part A premium because they or a spouse have sufficient Medicare-taxed work history.
The 2026 Part D out-of-pocket limit is $2,100 for covered prescription drugs. Part D premiums and drugs not covered by the plan are outside that limit.
| Cost | 2026 amount |
|---|---|
| Standard Part B premium | $202.90 per month |
| Part B deductible | $283 per year |
| Part D covered-drug out-of-pocket limit | $2,100 per year |
How IRMAA can affect your premiums
IRMAA stands for Income-Related Monthly Adjustment Amount. People above certain income thresholds pay an additional amount for Part B and Part D. It is separate from the premium charged by a private drug plan.
Social Security generally uses tax-return information from two years earlier. Retirement or another qualifying life-changing event may affect how your income is considered. Bring any notice and questions about an income change to the conversation.
Late-enrollment penalties
Enrolling late without qualifying coverage can create penalties. Part B and Part D have different rules, so ask about both. Employer medical coverage and creditable drug coverage are not interchangeable terms.
Understand the effect before you delay enrollment, drop coverage, or stop paying a premium. Keep coverage notices and records of employment-based insurance.
Compare a full year, not just a premium
Add expected premiums, prescriptions, routine visits, and the potential costs of more care. Consider whether you prefer more predictable monthly premiums or different cost-sharing when you use services.
If costs are difficult to manage, Medicare Savings Programs or Extra Help may be worth exploring.
Talk it through
Your questions belong here.
Julianne can help you understand how this applies to your own coverage and plans.
Call JulianneNo fee for Medicare guidance. Julianne is paid directly by insurance companies.
A conversation is a good place to start
You don't have to work this out alone.
Tell Julianne what's changing in your life. Together, you can work through your coverage questions and next steps.
Contact Julianne
What would you like help with?
Send a message or request a conversation. Julianne will follow up with you directly.
(805) 441-9093
support@wecaremedicareplans.com
Monday through Friday
8:00 am to 5:00 pm
Closed Saturday and Sunday
Serving San Luis Obispo and Santa Barbara counties, from Paso Robles to Lompoc. Meetings at your home or an agreed location. Before any in-home appointment, California law requires 24 hours’ written notice, which Julianne sends you in advance.