Expert Tips for Navigating Your Healthcare Choices | Dan Pascone with Michele Campbell | Ep #04

Michele Campbell is the founder and a broker at MC Insurance Services, an independent agency that focuses on Medicare. Her background is in human resources and employee benefits. She also ran her own electronics business in Silicon Valley, which meant she was a buyer of insurance for many employees.

She got licensed in 2006, and the move to independent agent felt natural for an entrepreneur. She entered the Medicare space 18 years before the recording and calls it a passion. In her words, people turning 65 or retiring usually find Medicare to be like a foreign language, so her role is to teach them the ABCs of Medicare and then look for a plan that lets them keep their doctors, fits their budget and meets their medical needs.

Michele says her ideal client is anyone who needs to get on Medicare. That includes people on an individual health plan who are about to turn 65, and people still working who are getting close to retirement. She suggests starting to educate yourself about 6 to 3 months before turning 65 or retiring, and then nailing down the details of a plan as the date gets closer.

It can also include someone who gets laid off and is about to move to COBRA. If someone has a retiree plan, she says they aren't her typical client, but they may not know whether it's a good plan. Her advice is to reach out and find out, because in some cases Medicare could cost less than the retiree plan. [VERIFY: that comparison is Michele's view and depends on the plan.]

Michele runs what she calls Medicare 101s, which are informational sessions. She prefers a webinar style but sometimes does a one-on-one Zoom call, and she keeps a recorded version on her website because she felt like a broken record repeating herself. The sessions break down Medicare Parts A, B, C and D, and she uses graphics because people are visual.

She presents to large medical groups, with as many as 300 people on a webinar who are new to Medicare or close to it. She says attendees often tell her they have never seen it laid out that way and that the question mark in their heads starts to get filled in. Dan noted that he's a big proponent of this kind of education before anyone is asked to buy anything.

Michele says the top challenges are understanding the cost of Part B and understanding how the parts fit together. She explains that Part A is premium-free for most people, that Original Medicare is Parts A and B, and that Parts C and D come from private insurance companies rather than directly from the government. [VERIFY: Part A premium-free eligibility depends on work history.]

The part that catches higher earners off guard is IRMAA. Michele explains that Medicare charges more for Part B to higher-income earners. She works in Silicon Valley, where she says many people have no idea how this works. They expect to pay the standard rate, which she put at around $185, and then find themselves paying $500 or $600 a month. Because the surcharge looks back 2 years at your income, she says planning ahead matters, and she also educates clients on how and when they can appeal. She says that knowledge alone has saved clients thousands of dollars. [VERIFY: figures are Michele's, from the 2025 recording. Premiums are updated every year.] The Centers for Medicare & Medicaid Services publishes the current numbers in its 2026 Medicare Parts A & B premiums and deductibles fact sheet.

Dan added that Medicare is a big component of retirement planning that often gets overlooked earlier in life.

Michele says there are far fewer insurance agents in the Medicare space than in property and casualty. Marketing is expensive and there are many compliance rules because the audience is 65 and older. Many agents work from home and meet clients at their houses, while she has an office.

After a long career, she says referrals are her number one source, and she tracks where every client comes from. They come from doctors' offices, medical groups, insurance carriers and her community. She also works with property and casualty brokers, group brokers and commercial brokers who refer Medicare clients to her. A less obvious source is HR: in several companies, the HR contact hands out her information as employees turn 65, and she does Medicare 101s for the group.

• Personal hack: Staying organized with email. Dan asked if she gets to email zero, and she said yes.

[ADD: Michele's other lightning round answers were not captured in the transcript provided (coffee or tea, cats or dogs, favorite tool, quote, book, bucket list item, financial milestone, money mistake and lesson, and advice to her younger self). Add them from the recording, or delete this section.]

The first thing people miss is that IRMAA looks backward. Because it uses a tax return from 2 years earlier, income you report in your early 60s can affect what you pay when Medicare begins. Large one-time events, such as a big equity sale, a deferred compensation payout or a retirement-year bonus, can show up in that lookback. We cover how one of those events works in How Is Deferred Compensation Taxed? The Exit-Year Decision Executives Underestimate.

The second is that some premium decisions can be revisited. Michele says clients can appeal in the right circumstances, which is why she educates people on when and why. Whether you qualify depends on your situation, so confirm the details with Social Security or a licensed professional. [VERIFY: appeal eligibility.]

We'd add a third from the planning side: Medicare is not a standalone decision. It sits next to your tax picture, your income plan and the timing of when you step back from full-time work. If you're considering a gradual transition, our blog Tired of Corporate, But Not Ready to Quit? There Is a Third Option. covers that path.

This example is hypothetical, uses assumed figures and is not a prediction. Suppose a married couple, both on Medicare, expects to pay a standard Part B premium of $185 a month each. Because of a high-income year 2 years earlier, assume each of them is instead billed a total of $550 a month for Part B.

• Extra cost per person: $365 a month, or $4,380 a year.
• Extra cost for the couple: $8,760 a year.
• Over 3 years: $26,280, if the higher bracket lasted that long.

Actual premiums and income brackets change each year and depend on filing status, so treat these as a way to size a line item. The planning question is whether that cost was in the retirement budget and whether the income event that caused it could have been timed differently or appealed. That is a conversation to have with your CPA and a licensed Medicare professional before the income year, not after.

We use Life-Driven Planning, our 6-phase process (Cash Flow, Retirement & Hybrid Retirement, Risk, Expense & Goal, Tax and Legacy), to build a plan around how you want to live. A Hybrid Retirement is a phased approach where full-time work gives way to flexible, optional work rather than an abrupt stop. Medicare touches several phases at once: Expense & Goal (the premium budget), Tax (managing income in the years that feed IRMAA) and Risk (coverage choices).

Our Life Driven Investing (LDI) approach builds the portfolio backward from your life, using the Four Liquidity Bands: money you'll need in 0–2 years, 3–5 years, 6–10 years and 10+ years. Healthcare costs in the near term shape what belongs in the nearer bands. We revisit it all in our Quarterly Strategy Rhythm, a regular check-in each quarter where we review the plan against what has changed.

We are a fee-only fiduciary firm. We don't recommend specific Medicare plans, and we don't provide insurance, tax or legal advice. Plan selection and enrollment are best handled by a licensed insurance professional, and we work alongside them and your CPA.

This conversation is for executives and business owners in their 40s–50s with household income of $500,000 or more, especially those with equity compensation, deferred compensation or a business sale on the horizon. If your income could swing from year to year, understanding how Medicare premiums are set, and when to plan for them, can help you avoid surprises in your 60s.

If you're thinking about how Medicare costs and the timing of your income fit into your retirement, tax and equity picture, we're happy to talk it through. The Free Wealth Strategy Call is a low-pressure conversation about your situation. Book a Free Wealth Strategy Call.