Approaching retirement or turning 65? Your healthcare options can be a maze. Employer plans, Medicare parts, supplemental coverage: it's a lot. But you don't have to sort it all out alone. Here are the main routes, from the standard path to newer models that build wealth. Some routes are open to anyone at 65, while others come through an employer while you're still working. That second group includes WellthCare™, the first Health-to-Wealth™ Benefit System, which rewards every verified preventive action with spendable dollars and automatic retirement contributions.
1. Traditional Medicare
Medicare is the federal health insurance program for people 65 and older, and it also covers some younger people with disabilities or end-stage renal disease. Two main parts:
- Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Most people get Part A premium-free if they or a spouse worked and paid Medicare taxes for at least 10 years (40 quarters).
- Part B (Medical Insurance): Covers doctor visits, outpatient care, preventive services, and medical supplies. Comes with a monthly premium, which is income-adjusted for higher earners.
But traditional Medicare doesn't cover everything. You're left with deductibles, copays, and no cap on out-of-pocket costs. That's why most retirees add supplemental coverage.
2. Medicare Supplement (Medigap) Plans
Private insurers sell standardized Medigap policies (Plans A through N) to fill those gaps. They cover some or all deductibles, copays, and coinsurance. The big draw is that you can see any doctor or specialist in the U.S. who accepts Medicare. The downside is that the monthly premium can be steep, especially for the plans that cover the most. Note that Plan C and Plan F closed to people who became eligible for Medicare on or after January 1, 2020, because they covered the Part B deductible. Plan G is now the fullest option for new buyers.
3. Medicare Advantage (Part C) Plans
Medicare Advantage is an alternative. Private insurers offer all-in-one plans that contract with Medicare. They bundle Part A, Part B, and often Part D (prescription drugs) into one plan. Many throw in extras like vision, dental, hearing, and gym memberships.
- Pros: Lower monthly premiums than Medigap, an out-of-pocket cap, and extra perks. Good if you want a one-stop managed-care plan.
- Cons: Network restrictions (HMO/PPO): you usually need to stay in-network. Prior authorizations are common for certain services.
4. Employer-Sponsored Retiree Health Plans
Some employers still offer retiree health benefits as part of a legacy package, but the share keeps shrinking. KFF's employer survey put it at 21% of large employers (200 or more workers) in 2023, down from 66% in 1988. Plans range from full medical coverage to a Medicare supplement or a health reimbursement arrangement (HRA) to help with premiums. If yours offers this, it's usually worth taking, but watch for restrictions and coverage changes. Make sure it coordinates with Medicare.
5. Health Savings Accounts (HSAs): Already Have One?
If you had a High Deductible Health Plan (HDHP) before retirement and contributed to an HSA, you're sitting on a goldmine. You can spend HSA money tax-free on Medicare premiums (Part A, Part B, Part D, and Medicare Advantage), deductibles, copays, and long-term care insurance premiums up to IRS limits. Medigap premiums are the exception: the IRS does not count them as a qualified medical expense. You can't keep contributing once you're enrolled in Medicare, but you can keep withdrawing for qualified expenses, and once you turn 65 you can also take money out for any reason without penalty, though non-medical withdrawals are still taxed as income.
6. The New Category: Health-to-Wealth Systems (Like WellthCare™)
Beyond covering costs, some benefits systems turn health into wealth, especially for people still working as they approach 65. Take WellthCare™. Instead of only paying claims, it rewards preventive health. Medicare-eligible employees earn reward dollars to spend at the WellthCare Store™, plus automatic deposits into a SEP/Pension account, for completing preventive scans and labs and staying on their medications.
For employees nearing retirement, the WellthCare Readiness Index™ uses an employer's own usage data to show when and how much a switch to WellthCare Medicare™ would save. That move cuts costs and improves outcomes by bundling pharmacy (WellthCare Pharmacy™), appointment reminders, and the reward system. The goal is to keep employees inside the system at 65 instead of falling off a cliff, so they keep earning, saving, and staying healthier. Employers reduce claim exposure and stabilize premiums at the same time.
One caveat: WellthCare is an employer-sponsored benefit, so access starts while you're still working, through your employer's plan, and continues into Medicare eligibility with WellthCare Medicare. It is not something you can buy on your own after you retire.
What Medicare Costs in 2026
Knowing the real numbers makes the choice clearer. For 2026, the standard Medicare Part B premium is $202.90 a month, and the Part B annual deductible is $283. The Part A hospital deductible is $1,736 per benefit period, and most people pay no Part A premium. Higher earners pay an income-related monthly adjustment amount (IRMAA) on top of the standard Part B and Part D premiums.
Original Medicare sets no annual limit on your share of costs. Medicare Advantage plans must cap in-network out-of-pocket costs at no more than $9,250 in 2026, with a $13,900 limit when out-of-network care is included, and many plans set lower limits. Part D drug costs have their own cap of $2,100 in 2026.
These are the baseline costs before any Medigap premium, Advantage plan premium, or employer subsidy. Line them up against what each option covers and the choice usually comes into focus.
Making the Right Choice for You
- Cost vs. Coverage. Compare monthly premiums against out-of-pocket maximums. A lower premium Advantage plan might cost you more if you get seriously ill.
- Provider Access. If you want to keep your current doctors, Original Medicare plus Medigap gives you the most freedom; Advantage plans restrict you to networks.
- Prescription Needs. Check your medications. Part D plans have formularies, so make sure yours are covered.
- Future Financial Security. Think beyond coverage. Systems like WellthCare™ that build savings from preventive care can offset rising healthcare costs later.
Retiree healthcare is changing. Original Medicare, Medigap, and Advantage plans still matter, but new models like WellthCare's Health-to-Wealth system show that benefits can do more than cover costs. They can build wealth. The question worth asking is what a plan pays you back.