Yes, billionaires can and do use Medicare, as it is a universal federal program for those aged 65 or older, regardless of income. While wealthy individuals often utilize private, concierge, or specialized, high-end, or international healthcare options, they may still enroll in Medicare for its base coverage, although some utilize legal loopholes to avoid paying Medicare taxes.
Medicare is the federal health insurance program for people 65 or older and serves individuals of all income backgrounds. However, it is skewed more towards those with lower incomes. Wealthy individuals must consider specific things regarding Medicare before enrolling.
Key demographics of the California Medicare population as of March 2021 (on Page 11) included: – 95.3% lived in urban counties. – 66.7% were White. – 68.1% were ages 65 through 79; 11.3% were under age 65; and 20.6% were ages 80 or older.
High-Deductible Health Plans (HDHPs) + HSAs: Many wealthy individuals use HDHPs combined with Health Savings Accounts (HSAs) for tax-efficient savings and to self-fund routine care.
Billionaires are using a loophole to avoid Medicare taxes. Closing it — and eliminating other ways around the tax for wealthy business owners — could raise more than $250 billion over 10 years for the program.
Taking Advantage of Capital Gains, Not Salary
One of the biggest reasons Bezos pays little in personal income tax is that he doesn't rely on a traditional salary. Instead, he holds most of his wealth in Amazon stock. Here's why this matters: Capital gains taxes are much lower than income taxes in most cases.
Californians with an annual income of less than $21,597 for an individual or $29,187 for a couple are eligible for a Medicare Savings Program. These programs provide help from the State of California to pay for your Medicare premiums, and sometimes your deductibles and copayments.
About 90% of millionaires build wealth through long-term investing, often focusing on real estate, starting their own businesses, and making consistent, disciplined financial choices like budgeting, saving, and continuous self-education, rather than flashy spending, with a strong belief in controlling their own financial destiny. They prioritize tangible assets and income streams, using strategies like leverage and tax benefits, and avoid excessive spending on depreciating assets like luxury cars.
If you are a U.S. citizen age 65 or older, you can get Medicare regardless of your work history — but your costs could vary. If you've paid Medicare taxes for at least 10 years, you can enroll in Medicare Part A.
If you file your taxes as "married, filing jointly" and your MAGI is greater than $218,000, you'll pay higher premiums for your Part B and Medicare prescription drug coverage. If you file your taxes using a different status, and your MAGI is greater than $109,000, you'll pay higher premiums.
The Ramsey team and Dave Ramsey himself recommend high-deductible health plans (HDHPs) whenever possible. That way, you can enjoy lower monthly premiums, and you'll qualify to open a Health Savings Account (HSA). You can use those savings to cover health expenses and even invest.
In 2025, purchasing $200,000-$300,000 worth of dwelling coverage cost an average of $140 per month or $1,679 per year, while coverage in the $800,000-$900,000 range cost $258 per month or $3,091 per year.
The 80% rule in home insurance means you must insure your home for at least 80% of its total replacement cost to receive full coverage for partial losses; if you insure for less, the insurer applies a penalty, reducing your payout proportionally, to prevent underinsurance and ensure you can actually rebuild. It's a guideline to cover the cost to rebuild from scratch (materials, labor, etc.), not market value, requiring homeowners to update coverage for renovations or rising costs to avoid significant out-of-pocket expenses.
The 3-6-9 rule in finance is a guideline for building an emergency fund, suggesting you save 3 months of essential expenses for stable jobs, 6 months for most people (especially those with families/mortgages), and 9 months for those with irregular income (freelancers, sole earners) or high financial risk. It's a flexible strategy to provide financial security, helping you avoid debt or panic withdrawals during unexpected job loss or emergencies, with the exact target depending on your income stability and dependents.
Billionaires, of course, tend to invest in the choicest lots and properties available, meaning they are always coveted, even if they may be only aspirational during uncertain economic times. Real estate, both residential and commercial, can also provide great returns.
Here are some of the biggest Medicare mistakes to avoid: