--- title: "Expert Tips for Navigating Your Healthcare Choices | Dan Pascone with Michele Campbell | Podcast #4" description: "Medicare is confusing, time-sensitive, and more expensive for high earners than most people realize. Dan and Medicare broker Michele Campbell of MC Insurance Services unpack the ABCs of Medicare, IRMAA surcharges, and how to choose plans that align with your doctors, medications, and retirement timeline." url: "https://yourtailoredwealth.com/podcasts/michele-campbell" lang: "en" published: "2025-02-28T00:00:00+00:00" modified: "2026-10-12T13:24:19+00:00" author: "Dan Pascone" --- # Expert Tips for Navigating Your Healthcare Choices | Dan Pascone with Michele Campbell | Ep #04 _Interactive content (form or widget). Open https://yourtailoredwealth.com/podcasts/michele-campbell in a browser to use it._ ## TL;DR Medicare is easier to handle when you start learning about it before you need it. In this episode, Dan talks with Michele Campbell, founder and broker at MC Insurance Services, about why she suggests people start educating themselves about 6 to 3 months before turning 65 or retiring, and why higher earners are often surprised by how Part B is priced. The biggest surprise she sees is IRMAA, the Income-Related Monthly Adjustment Amount, which adds to Part B premiums for higher-income households and is based on a tax return from 2 years earlier. For executives and business owners in their 40s–50s, the takeaway is that income decisions made in the years before 65 can shape your Medicare costs later, so they belong in your retirement plan. ## Who Is Michele Campbell? 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. ## Who She Helps and When to Start 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. \[VERIFY: that comparison is Michele's view and depends on the plan.\] ## Medicare 101 Sessions 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. ## The Big Surprise: Part B and IRMAA 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.](https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles) Dan added that Medicare is a big component of retirement planning that often gets overlooked earlier in life. ## How Clients Find Her and Who Refers 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. ## Lightning Round Highlights * **Personal hack:** Staying organized with email. Dan asked if she gets to email zero, and she said yes. \[ADD: Michele's other lightning round answers were not captured in the transcript provided (coffee or tea, cats or dogs, favorite tool, quote, book, bucket list item, financial milestone, money mistake and lesson, and advice to her younger self). Add them from the recording, or delete this section.\] ## What Most People Miss 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.](https://yourtailoredwealth.com/blog/how-is-deferred-compensation-taxed) 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.](https://yourtailoredwealth.com/blog/hybrid-retirement-for-executives) covers that path. ## Example (Hypothetical): What a Higher Part B Premium Could Add Up To 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. ## How This Fits Our Approach at Tailored Wealth 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. ## Who This Is For 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. ## Frequently Asked Questions ### When should I start thinking about Medicare if I’m approaching 65? Generally, Michele recommends starting **6–3 months before** you’ll need coverage. If you’re going to retire and go on Medicare at 65, begin learning and planning during that window so you understand enrollment periods, penalties, and your options. If you’re working past 65 and staying on employer coverage, start 6–3 months before your planned retirement date. ### Do I have to sign up for Medicare at 65 if I’m still working? Not always. It depends on: * The size of your employer * The quality and cost of your employer plan * Whether you (and your spouse) will continue working In many cases, you can delay some parts of Medicare without penalty if you have qualifying employer coverage, but the rules are nuanced. That’s why Michele’s firm encourages a **Medicare 101 conversation** well in advance. ### What is IRMAA and why might my Part B premium be higher than my friends’? **IRMAA** stands for _Income-Related Monthly Adjustment Amount_. Social Security looks at your **tax return from two years ago** to see if your income exceeds certain thresholds. If it does, they add a surcharge to your Part B (and sometimes Part D) premiums, which can push your total monthly cost into the **$500–$600+** range. ### Can I appeal IRMAA if my income has dropped? Often, yes. If you’ve had a qualifying life-changing event, like retirement, reduced work hours, marriage, divorce, or a significant income reduction, you may be able to **appeal IRMAA** and have your premiums recalculated. Michele frequently helps clients understand whether they’re eligible to appeal and how to complete the process. ### What’s the difference between Medicare Advantage and a Medicare Supplement? In brief: * **Medicare Advantage (Part C)** plans are offered by private insurers and typically wrap your Part A, Part B, and often Part D into one plan with networks and copays. * **Medicare Supplement (Medigap)** policies work alongside Original Medicare (Parts A & B) to help cover deductibles and coinsurance; Part D is usually a separate drug plan. The best option depends on your doctors, travel patterns, medications, budget, and risk tolerance. Michele’s firm walks clients through the pros and cons in their specific situation. ### How does a Medicare broker like Michele get paid? Typically, Medicare brokers are compensated by the **insurance carriers** when a client enrolls in a plan. Clients usually don’t pay brokerage fees directly, which means you can get professional help comparing plans without an additional out-of-pocket advisory charge. That said, it’s important to work with someone who is **independent** and focuses on fit, not just commissions. ### Why should my HR or benefits team care about having a Medicare partner? Employees turning 65 often bombard HR with questions about: * Whether to stay on the group plan or go to Medicare * How COBRA interacts with Medicare * Timing, penalties, and plan options Partnering with an independent broker like Michele gives HR a trusted expert to: * Run **Medicare 101 sessions** for staff * Provide individualized guidance * Help employees avoid costly mistakes That can reduce HR’s workload and improve the overall employee experience. ### How can a high-income year affect my Medicare premiums? Medicare uses a tax return from 2 years earlier to decide whether you owe an income-related surcharge on certain premiums. That means a large income event in your early 60s, such as a stock sale, a deferred compensation payout or a Roth conversion, can show up in what you pay once you're on Medicare. Our blog [When Does a Roth Conversion Actually Make Sense? Find Your Tax Window](https://yourtailoredwealth.com/blog/roth-conversion-tax-strategy) covers how we think about timing income. This is general education, not tax or insurance advice, and thresholds change each year. \[VERIFY\] ### What should I do about health coverage if I'm laid off or leave a job before 65? Start by listing your options and their deadlines. Common ones include COBRA, a spouse's plan or an individual policy, and each has its own cost and timing rules. Michele notes that a layoff can leave very little time before coverage ends, which is why she suggests learning the basics before you need them. COBRA is generally not treated the same as active employer coverage when it comes to delaying parts of Medicare, so confirm the rules for your situation with Medicare.gov or a licensed insurance professional. \[VERIFY\] ### How does Medicare fit into a retirement plan? It belongs in several places at once: your expense budget (premiums and out-of-pocket costs), your tax planning (income in the years that feed income-related surcharges) and your timeline for stepping back from work. We build those into one plan using our Life-Driven Planning process. Our video [Hybrid Retirement Plans Explained: Make Work Optional?](https://yourtailoredwealth.com/videos/hybrid-retirement-plans-explained-make-work-optional/) shows how we think about a phased transition. If you'd like to talk through your own numbers, [book a Free Wealth Strategy Call](https://yourtailoredwealth.com/book-a-call) with Tailored Wealth. It's a low-pressure conversation about your situation. ## Talk Through Your Own Plan 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](https://yourtailoredwealth.com/book-a-call). _Disclosure_ _The information provided is for educational and informational purposes only and does not constitute investment advice and it should not be relied on as such. It should not be considered a solicitation to buy or an offer to sell a security. It does not take into account any investor's particular investment objectives, strategies, tax status or investment horizon._ _No investment strategy or risk management technique can guarantee returns or eliminate risk in any market environment. All investments include a risk of loss that clients should be prepared to bear. The principal risks of Tailored Wealth’s strategies are disclosed in the publicly available Form ADV Part 2A._ _The views expressed in this commentary are subject to change based on market and other conditions. These documents may contain certain statements that may be deemed forward looking statements. Please note that any such statements are not guarantees of any future performance and actual results or developments may differ materially from those projected. Any projections, market outlooks, or estimates are based upon certain assumptions and should not be construed as indicative of actual events that will occur._ _Tailored Wealth and its advisors do not provide legal, accounting, or tax advice. Consult your attorney or tax professional. _