December 4, 2025, 4:00 PM ET
As you near retirement—or maybe even if it’s still years away—you likely have some awareness of Medicare. It’s a program that provides health insurance to millions of older Americans, funded by your paycheck through payroll taxes. Many also realize the importance of keeping social security intact.
Yet, there are facets of Medicare that might be less familiar to you. Here are five things to consider that could be eye-opening.
1. It’s not free
A common misconception is that joining Medicare is virtually without cost. That’s not quite how it works.
While most seniors don’t pay premiums for Medicare Part A, which covers hospital care, Part B does come with a monthly premium that can fluctuate annually. Additionally, Part D, which includes prescription drug coverage, typically requires a premium as well—though there are some plans available at no cost.
Besides the premiums, you might encounter copayments and coinsurance as a Medicare enrollee. These expenses can add up significantly.
To help manage these costs, many people look into supplemental insurance, often called Medigap, at the time they enroll in Medicare. Otherwise, you could find yourself draining your retirement savings more than you expected.
2. Original Medicare isn’t your only option
Don’t forget that Original Medicare (Parts A and B) isn’t the sole method for obtaining health insurance. There’s also the Medicare Advantage Plan, which is offered by private insurers.
Medicare Advantage plans can provide certain perks, like expanded coverage and annual out-of-pocket maximums. However, there are downsides as well, such as limitations in provider networks and often needing prior approval for more complex treatments.
It might be wise to investigate the Medicare Advantage options to see if enrolling in one could be beneficial for you. If it doesn’t work out, you can always drop it later, but it may be a way to save money.
3. Medicare includes telehealth services
As people age, going out for medical appointments can become more challenging. Thankfully, Medicare has broadened its telehealth services over recent years. Enrollees can now schedule virtual visits to get necessary care without the hassle of travel.
If you have Medicare, it’s a good idea to check what telehealth services are available to you. This is particularly useful if transportation is an issue or if you live in a rural area.
4. You can enroll in Medicare while still working
Some might assume they can’t sign up for Medicare while still employed. However, once you hit 65, you can enroll regardless of your employment status.
It might even make sense to register for Medicare alongside your job’s health insurance, as Medicare may be more comprehensive and cost-effective than what your employer offers.
On a side note, once you enroll in Medicare, you’re no longer able to contribute to a Health Savings Account (HSA). If you’re receiving this benefit through work, you should think about opting out.
This doesn’t prevent you from using an HSA after enrolling; you just can’t add more funds to it.
5. Delaying registration can have lasting costs
The initial Medicare enrollment period spans three months before your 65th birthday and three months after. If you don’t have access to eligible group health insurance through your job, it’s wise to enroll during this window. This ensures coverage and helps you avoid financial penalties.
If you wait to enroll, you could face a 10% surcharge on your Part B premium for every year you could have enrolled but didn’t—which is often a lifelong penalty. So, it’s best to enroll on time if at all possible.
Clearly, there’s much to learn about Medicare. Don’t hold off until just before you sign up to start getting informed. The sooner you familiarize yourself with how it works, the better you can strategize for your retirement.
