Yes, wealthy people use Medicare because eligibility isn't based on income, only age or disability, and they pay into it like everyone else, but they often use supplemental insurance (Medigap) or private plans (Medicare Advantage) to cover gaps, and pay higher premiums for some parts due to higher incomes, making strategic planning crucial for them. They utilize Medicare as foundational coverage but often layer it with private options for broader benefits, notes.
What Kind of Health Insurance Millionaires Use. Concierge or Executive Health Plans: These offer a more personal, high-touch model of care, often with 24/7 physician access and premium service.
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.
Medicare is health insurance for people 65 or older. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig's disease). More than 66 million people in the U.S. get their health coverage from Medicare.
Compared to traditional Medicare beneficiaries, Medicare Advantage enrollees were more likely to be Black or Hispanic, have incomes below $20,000 per person, and self-report fair or poor health, based on KFF analysis of the 2023 MCBS (Figure 2, Appendix Table 1).
If you can't afford Medicare costs, you can get help through Medicare Savings Programs (MSPs), which pay premiums/costs, and Extra Help, for prescription drugs (Part D), both for those with limited income/resources, plus programs like Medicaid (for low-income) and potentially PACE, or by checking with your state for State Pharmaceutical Assistance Programs (SPAPs). Contact your State Medicaid office or SHIP (State Health Insurance Assistance Program) to see what you qualify for, as eligibility rules vary by state.
Wealthy individuals must pay premiums based on income: the higher the income, the higher the Medicare premium. Even though the wealthy individual may not have a regular income, return on investments and income reporting on tax returns are considered in Medicare premium calculation. Medicare doesn't cover everything.
Even if a person is 65 years or older, they still may not be eligible for Medicare unless they are also a U.S. citizen or have been a lawful U.S. resident for at least 5 years. If they do not meet either of these requirements, they are not eligible for Medicare and must purchase health coverage elsewhere.
Demographic Details
The primary audience for Medicare Advantage is eligible individuals, typically starting at age 65. This age group has unique healthcare needs and concerns. Their life experiences shape their preferences.
Here are some of the biggest Medicare mistakes to avoid:
Each fall, when we ask the IRS for information to determine next year's premiums, we ask for tax information to verify your reports of changes affecting your income-related monthly adjustment amounts, if any. We also ask the IRS for your two-year-old MAGI if we've temporarily used three-year-old MAGI.
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.
Part A late enrollment penalty
If you have to buy Part A, and you don't buy it when you're first eligible for Medicare, your monthly premium may go up 10%. You'll have to pay the penalty for twice the number of years you didn't sign up.
The estimated cost of Medicare for All is around USD 32 trillion dollars over 10 years. Medicare for All would also require privately insured individuals to forgo their insurance and join the government program. The price tag and the requirement that all join makes Medicare for All unlikely to come to pass.
Your Original Medicare coverage does not run out as long as you pay the monthly premium (the monthly payment). If you have a Medicare Advantage plan, the company might stop offering that plan, but you'll have a chance to choose a new one.
Understanding your options is a critical first step to take in the process:
This is how much millionaire workers get from Social Security. An income of $1 million a year amounts to a monthly payment of about $83,333.33. Retirement benefits are generally designed to replace about 40% of pre-retirement income.
$0 for most people (because they paid Medicare taxes long enough while working — generally at least 10 years). This is sometimes called “premium-free Part A.” Do I qualify? If you don't qualify for a premium-free Part A, you might be able to buy it.