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Most people know that the American healthcare system can be confusing, but Medicare can be especially difficult to navigate. This is especially true for retirees and those who will be retiring soon. From gaps in coverage to reluctant enrollment, many elements of the federal healthcare program can be frustrating.
Personal finance guru dave ramsey and Ramsey Solutions Team Offered some thoughts on the Medicare program that might be useful to hear – even if you’re already enrolled. Here are some big ones.
Medicare basics
It helps to start with the basics. Generally, American workers become eligible for Medicare when they turn 65. People with qualifying disabilities can enroll soon.
coverage
Original Medicare enrollment – Parts A and B – covers many things, including doctors’ services, inpatient hospital care and preventive services. Coverage is based on state and federal law, but the program generally covers services deemed “medically necessary.”
However, Original Medicare doesn’t cover everything. Common exclusions are long-term care, routine physicals, and dentures.
There is also Medicare Part D, which covers prescription drugs and has its own coverage limits. People who need additional coverage can purchase Medicare supplement insurance (Medigap) or a Medicare Advantage plan (Part C). This may include things like vision, dental or hearing services.
Enrollment and costs
Medicare is not mandatory, but most people enroll in it at some point. People with Part A typically don’t have to pay a premium, although it depends. People with Part B paid an average premium of $175.70 per month in 2024. There are also annual deductibles — $1,676 for Part A in 2025 and $257 for Part B.
Part D renews automatically, which is convenient, but it is an additional cost. Similarly, Medicap and Part C cost extra, and you’ll have to manually re-enroll for these each year.
Why is this confusing?
According to Dave Ramsey, the program’s general rules can also be “confusing”. But why does he think so?
“Well, it was made by the government, so that might be your first clue,” the Ramsey Solutions post reads. “And second, it’s a lot to understand.”
This applies to both original Medicare and Medicare Advantage plans. Advantage plans function similarly to traditional health care plans: both have limitations in terms of their network providers.
Sometimes, the insurance company offering a Medicare Advantage plan won’t cover things like specialists — even if the enrollee is referred to them. This means that the nominee has to pay from his own pocket for all the associated costs of seeing that specialist.
People who have Medicare Advantage must pay separate premiums for both it and Medicare Part B. While Advantage plans can be useful, they aren’t the best option for everyone, according to Ramsey Solutions.
Current administration and medicine
People have been worried about the future of Medicare for years. Now, with passage of the One Big Beautiful Bill Act (OBCBA), what will Trump’s Medicare cuts look like?
- It has been estimated that OBBA could cut Medicare by $536 billion over a decade. A separation results in an automatic reduction in Medicare at the end of the year under the statutory Pay-As-You-Go Act (PAYGO).
- Under PAYGO, the enacted bill would result in cuts to Medicare of $45 billion in 2026, rising to $76 billion in 2034 for a total of $536 billion over the 2026 to 2034 period.
- It is also estimated that Trump’s tax cuts could lead to a potential $491 billion cut to Medicare from 2027 to 2034 if Congress does not take action to undo the 2010 law that forced cuts to many federal programs following legislation that increased the federal deficit.
The future of Medicare remains to be seen. For now, the best thing for current and future retirees to do is to keep an eye on their enrollment period, coverage options and out-of-pocket costs amid the growing involvement of public and private insurance companies.
Caitlin Moorehead contributed reporting to this article.
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