The True Cost of Medicare: What Virginia Beach Seniors Really Pay

The True Cost of Medicare: What Virginia Beach Seniors Really Pay

When Virginia Beach seniors ask me "What does Medicare cost?", they're often surprised to learn there's no simple answer. Unlike employer insurance with a single monthly premium, Medicare involves multiple costs that can vary dramatically based on your coverage choices, health needs, and income level.

After helping Hampton Roads residents understand Medicare costs for over 24 years, I've learned that many seniors underestimate their total healthcare expenses in retirement. Understanding all the costs involved is crucial for proper retirement planning and avoiding financial surprises.

Let me break down every Medicare cost so you can budget accurately and make informed decisions about your coverage.

Medicare Part A Costs: Not Always "Free"

Most people pay no premium for Medicare Part A (hospital insurance) because they or their spouse paid Medicare taxes during their working years. However, Part A still involves costs:

2026 Part A Costs:

• Premium: $0 for most people (some pay up to $505/month if they haven't paid enough Medicare taxes)

• Deductible: $1,676 per benefit period (when you're admitted to the hospital)

• Coinsurance: $419 per day for days 61-90 in the hospital

  
  

What This Means: Even "free" Part A can result in significant out-of-pocket costs if you need hospital care. A week-long hospital stay could cost you thousands in deductibles and coinsurance. A Medicare supplement plan can pick up these costs

Medicare Part B Costs: The Mandatory Monthly Expense

Medicare Part B covers doctor visits, outpatient care, and medical equipment. Part B costs affect everyone with Medicare.

2026 Part B Costs:

• Standard Premium: $206.50 per month (this is rising 11.6% from 2025)

• Deductible: $288 annually

• Coinsurance: 20% of Medicare-approved amounts for most services. Again a Medicare supplement plan picks the majority of this

  
  

Income-Based Adjustments (IRMAA): Higher-income individuals pay additional monthly premiums based on their income from two years prior. These adjustments can add $70-$419 per month to your Part B premium.

Virginia Beach Reality Check: If you're still working or have significant retirement income, you might face higher Part B premiums due to IRMAA surcharges.

Medicare Part D Costs: Prescription Drug Coverage Variables

Part D prescription drug coverage costs vary significantly by plan and the medications you take.

2026 Part D Costs:

• Premiums: Range from $0 to $200+ per month depending on the plan

• Deductible: Up to $615 annually (many plans have lower or $0 deductibles)

• Copays/Coinsurance: Varies by medication and plan tier

• Out-of-Pocket Maximum: $2,100 annually

  
  

Cost Calculation Complexity: Your actual Part D costs depend heavily on which medications you take and which plan you choose. A plan with a $0 premium might cost you more overall if your medications have high copays.

Medicare Supplement Insurance Costs: Predictable but Variable

Medicare Supplement (Medigap) plans help cover the costs that Original Medicare doesn't pay, like deductibles and coinsurance.

Typical Virginia Beach Supplement Costs:

• Plan G (most popular): $120+ for a 65-year-old, per month depending on insurance company.

• Plan N: $98-140+ per month

Cost Factors: Supplement premiums vary based on insurance company, your age, gender, zip code, and whether you smoke. In Virginia Beach, premiums can vary significantly between carriers for identical coverage.

Medicare Advantage Costs: The All-in-One Alternative

Medicare Advantage plans replace Original Medicare and often include prescription drug coverage and extra benefits.

Typical Medicare Advantage Costs:

• Premiums: $0 to $100+ per month 

• Deductibles: $0 to $500+ annually for medical services, $615 for prescription coverage

• Copays: $10-50 for doctor visits, $200-400 for hospital stays

• Out-of-Pocket Maximums: $3,000-$11,500 annually

Hidden Costs: While Medicare Advantage plans often have low or $0 premiums, your costs depend heavily on how much healthcare you use. High utilizers may pay more with Advantage plans than with Original Medicare plus supplements.

Additional Medicare-Related Costs to Consider

Dental Care: Original Medicare doesn't cover most dental services. Options include:

• Standalone dental insurance: $20-80+ per month

• Medicare Advantage plans with dental: Varies by plan

• Out-of-pocket costs: Can be substantial for major dental work

Vision Care: Medicare covers some eye care but not routine vision exams or glasses:

• Standalone vision insurance: $10-30+ per month

• Medicare Advantage vision benefits: Limited coverage

• Out-of-pocket vision costs: $200-500+ annually

Hearing Aids: Medicare doesn't cover hearing aids:

• Hearing aids: $1,000-$8,000+ per pair

• Some Medicare Advantage plans offer hearing aid benefits

Long-Term Care: Medicare provides very limited long-term care coverage:

• Long-term care insurance: $2,000-5,000+ annually

• Medicaid planning: May be necessary for extended care needs

  
  

Income-Based Medicare Costs (IRMAA)

Higher-income individuals pay additional premiums for both Part B and Part D based on their modified adjusted gross income from two years prior.

2026 IRMAA Brackets: The surcharges begin when your income exceeds $106,000 (individual) or $212,000 (married filing jointly) and can add hundreds of dollars to your monthly Medicare costs.

Planning Opportunity: Since IRMAA is based on income from two years ago, strategic retirement planning can help minimize these surcharges.

Hidden Costs That Surprise Virginia Beach Seniors

Provider Network Changes: Switching doctors because they're no longer in your plan's network can involve new patient fees and different treatment approaches.

Formulary Changes: When your Medicare plan removes your medication from its covered list, you might face much higher costs or need to switch medications.

Geographic Limitations: If you spend time outside Virginia, some Medicare Advantage plans may not provide coverage, leading to unexpected costs.

Budgeting Strategies for Medicare Costs

Track All Healthcare Expenses: Include premiums, deductibles, copays, and services not covered by Medicare.

Plan for Annual Increases: Medicare costs typically rise each year, so budget for 3-5% annual increases.

Consider Total Cost, Not Just Premiums: A plan with higher premiums might save you money overall if it covers your specific needs better.

Build an Emergency Fund: Unexpected healthcare needs can result in thousands in out-of-pocket costs even with good Medicare coverage.

How I Help Hampton Roads Residents Understand Medicare Costs

As your local Medicare broker, I provide cost analysis tailored to your specific situation:

Personalized Cost Projections: I calculate your expected annual costs based on your medications, healthcare usage, and plan options.

Plan Comparisons: I show you real-world cost comparisons, not just premium differences.

Budget Planning: I help you understand and plan for all Medicare-related expenses, not just the obvious ones.

Annual Reviews: Healthcare needs and costs change, so I review your coverage annually to ensure you're getting the best value.

Don't Let Medicare Costs Surprise You

Understanding Medicare costs is essential for retirement planning and avoiding financial stress. Many Virginia Beach seniors are shocked to discover that Medicare isn't free and that their total healthcare costs in retirement are higher than expected.

Call Retha Rish Insurance Agency at 757-692-8388 or 757-213-6910 to get a personalized Medicare cost analysis.

Don't guess about your Medicare costs. Get accurate projections based on your specific health needs and coverage preferences, so you can budget confidently for your healthcare expenses in retirement.