Episode
How Medicare Can Make or Break a Retirement Plan
- Podcast
- The What If Show
- Published
- Jun 24, 2026
- Duration seconds
- 2321
- Processing state
not_requested
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Summary
Medicare is one of the most expensive and most misunderstood variables in any retirement plan — and most clients don't see it coming. In this episode of The What If Show, Brooke Thomas and Steve Goldstein of Thomas Gold Solutions break down exactly why Medicare deserves its own dedicated chapter in every retirement plan you build. They cover the IRMAA surcharge tiers (and how a single dollar over the income threshold can spike a client's premiums), which types of income — including Roth conversions and capital gains — feed into that calculation, why the two-year look-back period creates planning blind spots, and how Medicare cost growth is quietly outpacing Social Security COLA increases in a way most advisors and clients haven't connected yet. They also tackle this episode's Retirement BS myth: that Medicare is a fixed, predictable cost you simply check off at age 65. It isn't — and the math Steve walks through at the end of the episode shows just how much is at stake. If you'd like the free IRMAA one-pager Thomas Gold has put together for advisors to share with their clients, email [email protected] . Chapters: 00:00 – Intro: The What If Show 00:07 – Welcome to Episode 5 00:53 – Why Medicare Is One of the Biggest Retirement Variables 01:33 – Healthcare Inflation: 5–7% vs. the 3.2% Average 03:29 – IRMAA Explained: What It Is and Why It Matters 05:44 – The IRMAA Tiers: From $202.90 to $689.90 Per Month 09:24 – The Cliff Tier Trap: $1 Over the Limit Changes Everything 10:55 – Medicare Parts A, B, C, and D: A Clear Breakdown 14:21 – Enrollment Timing and Late Penalty Warning 16:23 – How Retirement Analyzer Automates IRMAA Calculations 18:40 – What Counts Toward Your MAGI (Roth Conversions, Capital Gains & More) 19:20 – Why Spreadsheets Fail and Purpose-Built Softwa…