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In this episode, healthcare attorneys Joella Roland and Jason Reddish from Powers join to provide commentary on a variety of developments impacting 340B covered entities. They'll discuss ongoing manufacturer activity, from contract pharmacy restrictions to claim data submission requirements, and how 340B providers have been responding. They'll also share some opinions on how recent judicial rulings on HRSA policy, including child site eligibility timing and GPO Prohibition, have impacted regulatory enforcement of the 340B Program. They'll also offer some thoughts on how recent proposed CMS rules related to Medicare Part B billing and Medicare Part D 340B data collection will impact covered entities in the future. In the intro, Greg and Rob recap changes that have been made to the HRSA Data Request List for FY27. Save the date for our upcoming 340B CE webinar on Tuesday, September 29th. Questions? Email us at 340BUnscripted@spendmend.com
In this episode of Financial Focus, host Peter and John Kuykendall, founder and CEO of Gulf Coast Financial Services, break down what it really takes to fund a comfortable retirement. While many approach retirement savings as a single lump-sum goal, the reality involves managing ongoing, recurring expenses over several decades. In this episode, we discuss: The Reality of Daily Expenses: Why housing, food, transportation, and utilities continue to be major budget items, even if your home is paid off. The Big Variable Costs: How taxes, rising inflation, and healthcare expenses—including Medicare Part B and potential long-term care—impact your overall strategy. The Phases of Retirement: Navigating spending patterns across your "go-go," "slow-go," and "no-go" years without running out of discretionary funds. Building a Personal Roadmap: Why relying solely on Social Security or general averages falls short, and how a structured, written retirement income strategy helps align your assets with your long-term needs. John Kuykendall is registered with and securities are offered through Kovack Securities, Inc. Member FINRA/SIPC. 6451 North Federal Highway, Suite 1201, Fort Lauderdale, FL 33308 (954) 782-4771. Advisory Services are offered through GulfCoast Financial Services, Inc., a Registered Investment Advisor in Florida. GulfCoast Financial Services, Inc. is not affiliated with Kovack Securities, Inc. or Kovack Advisors, Inc. John Kuykendall may discuss/transact securities related business in: CA, FL, ID, and OK. "Likes", endorsements, and other recommendations should not be considered a positive reflection of the services or advice offered by John Kuykendall or GulfCoast Financial Services; positive reviews of experience with John Kuykendall or GulfCoast Financial Services may not reflect the experience of all, or even most, clients. Visitors to this page should not write positive reviews of their experience as testimonials may be prohibited under state and federal securities laws.
Medicare may be one of the most important—and confusing—financial decisions you make in retirement. Between enrollment deadlines, late penalties, Medicare Advantage, Medigap, prescription coverage, and income-based premiums, there are plenty of decisions to navigate. And because some choices can have long-term financial consequences, understanding the basics before you enroll is an important part of wise stewardship. Eddie Holland, Senior Private Wealth Advisor and Partner at Blue Trust, as well as a CFP®, CPA, and Certified Kingdom Advisor®, recently joined Faith & Finance to help simplify Medicare and explain some of the most important planning considerations. Understanding Medicare Parts A, B, C, and D A good place to begin is with Medicare's different parts. Medicare Part A primarily covers hospital-related care, including inpatient hospital stays, skilled nursing care, and hospice. For people who have accumulated the required work credits through either their own employment or their spouse's, Part A generally does not require a monthly premium. Medicare Part B covers many medical services outside the hospital, including doctor visits, lab work, and outpatient procedures. Unlike Part A, Part B generally carries a monthly premium, and higher-income retirees may pay more. Medicare Part D covers prescription drugs. Those enrolled in Original Medicare—Parts A and B—can generally purchase a separate Part D prescription drug plan. Medicare Part C, better known as Medicare Advantage, is offered through private insurance companies. These plans combine Parts A and B and often include Part D prescription coverage as well. Some plans may also offer additional benefits such as dental or vision coverage. Another option for those using Original Medicare is a Medicare supplement plan, commonly called Medigap. These private plans are designed to help cover some of the deductibles, copayments, and other expenses that Original Medicare does not pay. Pay Close Attention to Enrollment Timing Timing matters when enrolling in Medicare. Your Initial Enrollment Period generally lasts seven months: the three months before the month you turn 65, your birthday month, and the three months afterward. But turning 65 does not always mean you have to immediately leave employer-sponsored health coverage. If you or your spouse are still working and you have qualifying employer coverage, you may have access to a Special Enrollment Period, allowing you to delay certain portions of Medicare without facing a late enrollment penalty. Holland notes that employer size and the nature of the coverage can affect how Medicare coordinates with the employer plan. That makes it important to speak with your employer's benefits or human resources department before making assumptions about which coverage should come first. Employer Size Can Make a Difference If your employer has 20 or more employees, the employer health plan may generally remain the primary payer while you continue working, potentially allowing you to postpone Part B and its monthly premium. With an employer of fewer than 20 employees, Medicare may become the primary payer once you are eligible. In that situation, failing to enroll in Parts A and B could potentially leave gaps in coverage. You should also verify whether your employer's prescription drug coverage is considered creditable coverage for Medicare purposes. That can be especially important if you plan to delay Part D beyond age 65. The larger lesson is simple: Medicare decisions should rarely be made in isolation. Your employer coverage, retirement date, spouse's coverage, prescription needs, and other factors all need to be considered together. What Is IRMAA? For higher-income retirees, another important acronym to know is IRMAA, or the Income-Related Monthly Adjustment Amount. IRMAA is an additional charge added to Medicare Part B and Part D premiums when modified adjusted gross income exceeds certain thresholds. For 2026, Holland notes that IRMAA begins above $109,000 in modified adjusted gross income for single filers and $218,000 for married couples filing jointly. Medicare generally bases the surcharge on the most recent tax information available, which often means looking back two years. So, for example, 2026 Medicare premiums may be based on income reported on a 2024 tax return. That two-year lookback can surprise people whose financial situation has recently changed. If your income has fallen because of certain qualifying life-changing events, such as retirement, marriage, or widowhood, you may be able to request a reconsideration of the surcharge using Social Security Form SSA-44. Roth Conversions Can Affect Medicare Premiums IRMAA can also become an important consideration when planning Roth conversions. Suppose you retire before age 65 and decide to convert a significant amount of traditional IRA money to a Roth IRA. The conversion increases your taxable income for that year. Because Medicare looks back at previous tax returns when determining IRMAA, a large Roth conversion in the years immediately preceding Medicare enrollment could lead to higher Part B and Part D premiums later. That doesn't necessarily mean you shouldn't complete the conversion. It simply means you should include the potential Medicare impact in the calculation. Tax planning, retirement planning, and Medicare planning are often interconnected. A decision that makes sense in one area can create consequences in another. Be Careful With HSA Contributions Health Savings Accounts require special attention as you approach Medicare eligibility. Once you are enrolled in Medicare, you can no longer contribute to an HSA. If you enroll around age 65, you need to coordinate the end of your HSA contributions with the beginning of your Medicare coverage. The issue becomes even more important for those who enroll after age 65 because Medicare Part A coverage can sometimes be applied retroactively, potentially affecting HSA eligibility for previous months. Holland recommends understanding the retroactive period before enrolling so you don't inadvertently make excess HSA contributions. Social Security can complicate matters further. If you begin receiving Social Security benefits, you may automatically be enrolled in Medicare Part A. Anyone who is still contributing to an HSA should account for that before applying for Social Security. The good news is that money already accumulated in an HSA remains tax-advantaged and can still be used for many qualified medical expenses in retirement, including certain Medicare premiums. Holland notes, however, that HSA funds cannot be used tax-free to pay Medigap premiums. What If One Spouse Reaches Medicare Age First? Married couples can face another challenge when one spouse becomes eligible for Medicare while the other is still several years away. If the older spouse continues working, the employer plan may continue covering both spouses. Some companies also provide retiree benefits that extend coverage to a younger spouse after the older spouse retires. If employer coverage isn't available, COBRA may provide temporary coverage, although it can be expensive. Another possibility is purchasing insurance through the federal or state health insurance marketplace, where the younger spouse may qualify for premium subsidies depending on household circumstances. Whatever option you choose, don't overlook the cost. If one spouse retires several years before the other reaches Medicare eligibility, higher healthcare premiums may need to become a deliberate part of the retirement budget. Make Medicare Part of Your Larger Retirement Plan Medicare isn't simply a healthcare decision. It can affect your taxes, retirement income, Social Security strategy, HSA contributions, and monthly spending. That's why careful planning before age 65 can be so valuable. Understand what each part of Medicare covers. Know your enrollment windows. Talk with your employer before leaving workplace coverage. Consider the impact of your income on Medicare premiums. And coordinate decisions involving HSAs, Roth conversions, Social Security, and your spouse's health coverage. Medicare may be complicated, but you don't have to approach it blindly. Taking the time to understand your options can help you avoid costly mistakes, choose coverage that fits your circumstances, and steward the resources God has entrusted to you with greater wisdom and confidence. On Today's Program, Rob Answers Listener Questions: I have a mortgage and a car loan and am considering consolidating them into one payment. Is that a good idea, and what type of loan would make sense? I received a letter saying my student loans were placed in permanent disability status, but I never applied for that. How can I verify whether it's legitimate and correct the situation if needed? Resources Mentioned: Faithful Steward: FaithFi's Quarterly Magazine (Become a FaithFi Partner) Blue Trust Christian Healthcare Ministries (CHM) | Healthcare.gov AnnualCreditReport.com FaithFi Field Guide: How Much Money is Enough? Our Ultimate Treasure: A 21-Day Journey to Faithful Stewardship by Rob West Wisdom Over Wealth: 12 Lessons from Ecclesiastes on Money Look At The Sparrows: A 21-Day Devotional on Financial Fear and Anxiety Rich Toward God: A Study on the Parable of the Rich Fool Find a Certified Kingdom Advisor® (CKA) FaithFi App Remember, you can call in to ask your questions every weekday at (800) 525-7000. Faith & Finance is also available on Moody Radio Network and American Family Radio. You can also visit FaithFi.com to connect with our online community and partner with us as we help more people live as faithful stewards of God's resources. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
In this episode of Financial Focus, John Kuykendall of Gulf Coast Financial Services discusses the connection between 401(k) withdrawals and Social Security benefits. The conversation explores how distributions from tax-deferred accounts can impact Social Security taxation, Medicare Part B premiums (IRMAA), and required minimum distributions (RMDs), as well as strategies like Roth conversions and planning for surviving spouses. John Kuykendall is registered with and securities are offered through Kovack Securities, Inc. Member FINRA/SIPC. 6451 North Federal Highway, Suite 1201, Fort Lauderdale, FL 33308 (954) 782-4771. Advisory Services are offered through GulfCoast Financial Services, Inc., a Registered Investment Advisor in Florida. GulfCoast Financial Services, Inc. is not affiliated with Kovack Securities, Inc. or Kovack Advisors, Inc. John Kuykendall may discuss/transact securities related business in: CA, FL, ID, and OK. "Likes", endorsements, and other recommendations should not be considered a positive reflection of the services or advice offered by John Kuykendall or GulfCoast Financial Services; positive reviews of experience with John Kuykendall or GulfCoast Financial Services may not reflect the experience of all, or even most, clients. Visitors to this page should not write positive reviews of their experience as testimonials may be prohibited under state and federal securities laws.
Your TSP has some of the lowest fees in the country — but a low-fee investment account is not the same thing as a written retirement income plan. In this short video, Charles explains what a real federal retirement plan actually coordinates, and what it costs you every year you wait.━━━━━━━━━━━━━━━IN THIS VIDEO YOU CAN LEARN━━━━━━━━━━━━━━━- Why low TSP fees don't add up to a retirement plan- What a real plan coordinates: FEHB, Medicare Part B, survivor benefits, and Social Security timing- How tax-deferred savings turn into RMDs — and who picks the number if you don't- The Medicare Part B cycle that quietly raises your costs as your income rises- The two things every written retirement income plan should start withWhat worries you more — paying higher fees, or not having a plan at all? Drop it below
Your TSP withdrawals can trigger consequences you never see coming — and sometimes "doing nothing" is the biggest mistake of all. In this short video, Charles walks through the TSP withdrawal traps that quietly cost federal retirees: lump sums that bump your tax bracket, Medicare premium spikes (IRMAA), a hidden jump in how much of your Social Security gets taxed, and RMDs that take the wheel if you don't plan.━━━━━━━━━━━━━━━IN THIS VIDEO YOU CAN LEARN━━━━━━━━━━━━━━━- How a big lump-sum withdrawal can push you into a higher tax bracket- How TSP withdrawals can spike your Medicare Part B premium (IRMAA)- How you can accidentally make more of your Social Security taxable- Why doing nothing lets RMDs — and the IRS — take control in your 70s- Why "purposeful and intentional" withdrawals need a written planAre you planning your TSP withdrawals — or leaving it alone and hoping it works out? Drop a Y or N
A surviving spouse may retain much of the household income—but suddenly face higher Medicare premiums and tax brackets. In Money Matters Episode 348, Christopher Hensley speaks with IRMAA Certified Planner Mark Annese about the widow's Medicare penalty and other retirement decisions that can trigger IRMAA. IRMAA—the Income-Related Monthly Adjustment Amount—is an additional charge applied to Medicare Part B and Part D premiums based on income reported two years earlier. Roth conversions, required minimum distributions, investment sales, and other seemingly reasonable financial decisions can create unexpected Medicare costs later. In this episode: • What IRMAA is and how the two-year income lookback works • Why the death of a spouse can create a "widow's penalty" • How Roth conversions and RMDs may affect Medicare premiums • When an SSA-44 appeal may be available after a life-changing event • Why Medicare planning should be coordinated with retirement and tax planning • How advisors can model potential IRMAA consequences before decisions are made Guest: Mark Annese, IRMAACP™ IRMAA Certified Planner, Advisor Coach, and Solutions Architect Retirement Advisor Pro: https://www.retirementadvisorpro.com Host: Christopher Hensley, RICP®, CES® Money Matters Podcast: https://www.moneymatterspodcast.com Watch the video episode: https://youtu.be/ObQJ6HQhdj4 This program is provided for educational purposes only and does not constitute individualized investment, tax, legal, or Medicare advice. Medicare premiums, income thresholds, and regulations change over time. Consult qualified professionals about your individual circumstances.
Toni explains Medicare Supplements and Medicare Advantage PPO Plans and the benefits each program offers. Toni explains Medicare Part A, Medicare Part B and Medicare Part D. Visit www.tonisays.com for Toni's Medicare information. There's so much good information in this podcast, please be sure to share this podcast with your friends! Recognized by feedspot.com as one of the best Medicare Podcasts in the nation! Write Toni - info@tonisays.com. Toni's book is available at www.seniorresource.com and www.tonisays.com You can call Toni at 832-519-8664 Toni welcomes all Medicare questions. You can find Medicare Moments wherever you find your favorite podcasts, such as: Apple: https://apple.co/44MoguGSpotify: https://open.spotify.com/show/7c82BS4hb145GiVYfnIRsoAmazon Music: https://music.amazon.com/podcasts/884c1f46-9905-4b29-a97a-1a164c97546b/medicare-moments?refMarker=null Toni's new book: Maze of Medicare is now available at www.tonisays.com Combining Scripture with Medicare, it is the only book of its kind. Toni's columns appear weekly in about 100 newspapers across America. If you would like Toni's column to appear in your local paper, or if you would like Toni to speak at an event - contact Toni King at 832-519-8664 Thank you for listening and be sure to tell your friends about Medicare Moments! Blessings!See omnystudio.com/listener for privacy information.
92507 is changing, and SLP documentation will have to change with it.In this episode, Jeanette Benigas, PhD/SLP, is joined by adult and pediatric private practice owners Katie Brown, MA/SLP, and Emily Watkins, MCD/SLP, to talk about what the new code set could mean for documentation, billing, compliance, and audit risk across pediatric and adult settings.Katie and Emily share firsthand experiences with Medicare, Medicaid, and commercial insurance audits, including what payers requested, what triggered the audits, and why documentation supporting medical necessity and skilled intervention matters. They also deliberate one of the biggest shifts ahead: moving from a catch-all code to multiple service-specific codes means SLPs will need to clearly support what they treated, why it required skilled intervention, and the time spent providing that treatment.The takeaway: do what you bill, bill what you do, and document what you do.Whether you're a clinician, manager, or private practice owner, now is the time to understand the changes and prepare... before January.Resources Mentioned
Eric Hansen is the founder and CEO of Burst Billing, a medical billing company on a mission to help nursing homes reclaim the Medicare Part B supply reimbursements they're owed and almost never collect. He got his start in senior care as a CNA before moving into portable x-ray and lab sales, where he saw firsthand how the system's "medicine by prophecy" approach — over-supplying to be safe — quietly drained facilities' already-thin margins. He walked away from a six-figure salary to bet that nine out of ten nursing homes were giving their profits away, and that he could win it back for them. In just two years, Burst Billing has grown to 17 states and recovered more than $1 million in reimbursements for its clients. Self-taught in AI with over 2,000 hours behind him, Eric has built a fleet of agents that keep his company lean — and he's refreshingly candid that his ultimate goal is to make Burst unnecessary by helping the entire industry collect these dollars on its own.Show Notes:00:00 — Introduction02:01 — Meet Eric Hansen: the bet that 9 of 10 nursing homes are giving profits away03:44 — From CNA to founder: how Eric got into senior care and spotted "medicine by prophecy"06:31 — Going all in: disproving the model, the weekend that changed everything, proving yourself wrong10:13 — On the naysayers: "You'll stop caring what others think when you realize how little they do"12:31 — What is a Part B supply? The reimbursements nursing homes leave on the table, and why "free" is expensive16:21 — The math: 2% margins, $500/day beds, and profit "like filling five beds without filling a bed"18:51 — The elephant in the room: why billing for more actually reduces Medicare fraud, waste, and abuse23:18 — Growing Burst Billing: 17 states, $1M+ recovered, and a company designed to disappear26:08 — Handing work to AI agents: the first job to delegate, goal-based AI, and the line never to cross32:19 — Starting from zero with AI: the learning curve, Notebook LM, and MVP discipline36:34 — AI in everyday life: relationship management, staying lean, fighting misinformation39:39 — A parting thought: the 9.7M caregiver shortage and whether AI could bring people back home41:38 — Closing thoughts
Chris returns on the air this week with Drew as they talk to callers regarding the Japanese yen and the US helping to not let it fall, firefighter DROP options, annuities, beneficiaries, Medicare Part B, and more! Download and enjoy!
The new Medicare speech therapy CPT codes are coming, and adult SLPs need to prepare.In this episode, Jeanette Benigas, PhD/SLP, is joined by Katie Brown, SLP of Neuro Speech Solutions (@neurospeechsolutions), to discuss how the new code family replacing 92507 could impact adult speech-language pathology across Medicare Part B, skilled nursing, outpatient, home health, hospital outpatient, and private practice.They discuss how the new codes may affect reimbursement, scheduling, productivity, documentation, cognition treatment, Medicare Advantage, commercial insurance, and ethical billing. They also explore why accurate utilization data will be critical to future advocacy for higher reimbursement rates.Whether you own a private practice, work in a SNF, outpatient clinic, hospital, or even pediatrics, this conversation will help you understand what's changing, what questions remain unanswered, and how to start preparing now.Topics include:• The new adult SLP CPT codes• Replacing 92507• Medicare Part B billing• Cognition reimbursement• Documentation changes• Productivity concerns• Private practice and SNF implications• Ethical billing and future advocacyResources Mentioned
This week on Financial Planning: Explained, host Michael Menninger, CFP®, welcomes back Cheryl Lagunilla, Health Insurance Advisor at Focused Health Access, to continue their Medicare discussion with a practical, real-world case study and an in-depth look at IRMAA (Income-Related Monthly Adjustment Amount). Building on the Medicare fundamentals covered in Part I, Mike and Cheryl walk through a realistic Medicare planning scenario to demonstrate how coverage decisions, enrollment timing, and income can affect healthcare costs in retirement. They also explain how IRMAA works, who is affected, and why higher-income retirees may pay increased premiums for Medicare Part B and Part D. The conversation highlights common situations retirees face when enrolling in Medicare, strategies for minimizing unexpected costs, and the importance of incorporating healthcare planning into an overall retirement strategy. Whether you're nearing Medicare eligibility, already enrolled, or helping a loved one navigate the process, this episode offers practical insights to help you make more informed decisions. Listeners will gain valuable insight into: What IRMAA (Income-Related Monthly Adjustment Amount) is and how it works How income affects Medicare Part B and Part D premiums A real-life Medicare case study and planning example Common Medicare enrollment and planning mistakes Strategies to help reduce unexpected Medicare costs How healthcare decisions fit into a comprehensive retirement plan Tips for evaluating Medicare coverage based on your personal situation Why proactive Medicare planning can help you avoid costly surprises Understanding how Medicare premiums are calculated—and how your financial decisions can impact your healthcare costs—is an essential part of retirement planning. This episode provides practical guidance and real-world examples to help simplify Medicare planning and prepare you for the road ahead. For more information on Menninger & Associates Financial Planning, visit: https://maaplanning.com.
Our recent blog post about a Medicare Part B vaccine billing update highlighted a clarification from Centers for Medicare & Medicaid Services. In this GAAP episode, our VP and health care cost report expert, Mark Lyons, provides a little more color to the situation and what it means for Rural Health Clinics and Federally Qualified Health Centers. Take 10 minutes to listen in to learn more!
Markets never stop moving, and neither do the conversations that matter most to investors and future retirees. Join Wes Moss and Connor Miller on this episode of the Money Matters Podcast as they break down the latest retirement planning, investing, financial planning, and personal finance headlines with historical perspective and practical context. • Find out how the latest inflation data may influence Federal Reserve policy and interest rate expectations. • See what early projections for the 2027 Social Security COLA—and rising Medicare Part B premiums—may mean for retirement income planning. • Compare wage growth and inflation to better understand what's happening with purchasing power. • Explore the buzz around IPOs while examining what history suggests about IPO investing versus long-term index investing. • Discover how stocks, bonds, and cash have historically performed after inflation across different investment time horizons. • Consider how oil prices, global events, and corporate earnings may influence market volatility and investor sentiment. • Follow the broadening earnings story across the S&P 500, including the growing impact of artificial intelligence spending and wider sector participation. • Learn about the retirement planning tools and bonus resources available with The Retire Sooner Method. Listen to the Money Matters Podcast for more conversations connecting today's headlines with retirement planning, investing, financial planning, and personal finance. Subscribe wherever you get your podcasts so you never miss a new episode.
In this episode, Greg and Rob are joined by Ted Slafsky and Will Newton of 340B Report. They recap major developments in the first half of 2026 that have impacted the 340B community. They'll discuss recent Congressional activity, including a newly introduced 340B Program reform bill (SECURE 340B Act), trends in federal administrative agency policies from HRSA and CMS, and the evolution of various manufacturer actions within the 340B Program. In the intro, they discuss recent HRSA audit finding trends and highlight key provisions in the CMS 2027 OPPS proposed rule, including anticipated Medicare Part B reimbursement reductions for 340B hospitals. Use “SPENDMEND25” to get a 25% discount on a subscription to 340B Report: https://340breport.com/subscribe/ Going to the 340B Coalition Summer Meeting? Come see us at booth #418.
Drew is solo this week as he talks to callers and answer questions regarding Medicare Part B late enrollment fee, signing up for Medicare, ACA enrollment, scams, 401k rollovers, and more! Download and enjoy!
Medicare brings peace of mind to millions of retirees, but for those with higher incomes, there's an added layer of complexity called IRMAA—the Income Related Monthly Adjustment Amount. If your modified adjusted gross income (MAGI) crosses certain thresholds, you may end up paying substantially more for your Medicare Part B and Part D coverage. In this article, we break down how IRMAA works, outline common scenarios that may unexpectedly raise your premiums, and offer actionable strategies to help you avoid unnecessary costs during your retirement years. You will want to hear this episode if you are interested in... [02:14] How IRMAA works [04:09] IRMAA income brackets and premium increases [05:43] General strategies and limitations for avoiding IRMAA [09:49] Managing Capital Gains and Medicare costs [10:41] Understanding the possibility of unexpected large gains pushing income higher [12:37] Impact of spouse passing on taxes [14:54] Avoiding IRMAA surcharge What Is IRMAA, and How Does It Work? IRMAA adds a surcharge to your standard Medicare Part B and Part D premiums if your income exceeds specific limits. The calculation uses your Modified Adjusted Gross Income (MAGI) from your federal tax return for the prior two years. For example, your 2026 Medicare premium is determined by your 2024 tax return figures. This "two-year lag" means financial decisions made today could impact your healthcare costs down the line. In 2024, the standard Part B premium is $202.90 per month. However, single filers reporting over $109,000 or married couples filing jointly above $218,000 pay $284 each per month, per person. Surpassing $137,000 (single) or $274,000 (joint) pushes your premium to $405.90—more than double the baseline. Part D premiums are also subject to surcharges, ranging from $14.50 to $91 per month at the highest income levels. Seven Scenarios That Can Trigger IRMAA—and How to Prepare While some situations are unpreventable, being aware of these common scenarios can help you make informed choices and potentially minimize your IRMAA exposure. 1. Municipal Bond Income: Not as Tax-Free as You Think Many investors favor municipal bonds for their federal tax-exempt status. Unfortunately, while this income is absent from your regular AGI, it is added back into your MAGI when calculating IRMAA. If you're relying heavily on munis in retirement, this could unexpectedly inflate your Medicare premiums. Consider alternative investments or relocating those assets into accounts or vehicles where this income is shielded, like certain annuities, after consulting with a qualified financial advisor. 2. Capital Gains on Your Home Sale When selling your primary residence, you can exclude up to $250,000 of gain if single or $500,000 if married, provided you meet the two-out-of-five-years residency rule. Gains above these thresholds are taxable and count toward your MAGI. Good record-keeping for home improvements can help increase your cost basis and reduce the taxable gain, but there aren't many strategies to avoid this spike if a large gain is unavoidable. 3. Profits from Investment Property Sales Selling an investment property can generate significant capital gains. But unique to investment real estate, the IRS allows you to defer these gains through a 1031 exchange—selling one investment property and reinvesting the proceeds into another. This move postpones the tax hit and the associated IRMAA impact, possibly indefinitely if you use the stepped-up basis at death. 4. Surprise Mutual Fund Capital Gains If you own mutual funds outside retirement accounts, unexpected capital gains distributions from within the fund (for example, after large stock sales like Apple) could spike your MAGI. To mitigate this, consider shifting from mutual funds to individual stocks, bonds, or exchange-traded funds (ETFs), which typically generate fewer surprise capital gains. 5. Roth Conversions are Great for Taxes, But Be Careful While Roth conversions can be powerful tax strategies, converting a sizable sum from a pretax IRA to a Roth IRA counts as income for IRMAA purposes. Carefully plan the size and timing of conversions to avoid pushing yourself into a higher premium bracket without realizing it. 6. The Financial Impact of Losing a Spouse Widowhood or widowerhood can be doubly difficult; not only do you suffer personal loss, but your filing status shifts to single, drastically lowering the income thresholds for IRMAA. If you expect changes in income or status, make proactive plans with your advisor to help smooth your MAGI. 7. Large, One-Time Retirement Account Withdrawals Big withdrawals from IRAs or 401(k)s—perhaps to buy a car or fund a vacation home—could catapult your income into a higher IRMAA tier. Consider spreading large purchases over several years or evaluating alternative financing options to keep retirement account withdrawals more manageable. Small Decisions Add Up While IRMAA might not be avoidable for everyone, being strategic about income sources, withdrawals, and investment choices can reduce surprises and keep more of your retirement income where it belongs—with you. Always consult with a financial advisor familiar with your unique situation before making significant financial moves. Keep your knowledge current and your planning proactive to support a more cost-effective retirement. Resources Mentioned Retirement Readiness Review Subscribe to the Retire with Ryan YouTube Channel Download my entire book for FREE 2026 Medicare Part B Premium Surprises, #282 7 Ways to Lower Your Income and Avoid the IRMAA Medicare Surcharge, #142 Mistakes To Avoid During Medicare Open Enrollment with Danielle Roberts, #229 Connect With Morrissey Wealth Management www.MorrisseyWealthManagement.com/contact Subscribe to Retire With Ryan
When it comes to Medicare, most people focus on coverage… but not enough attention is paid to what you'll actually pay. As Peter with Richon Planning explains to Erin Kennedy, if you're considered a "high-income beneficiary" by the Social Security Administration, you could be hit with an extra charge called IRMAA (Income-Related Monthly Adjustment Amount)… and it can significantly increase your Medicare Part B premiums. Here's what you need to know
In this final part of the Retire With Style Live Q&A, Wade Pfau and Alex Murguia answer a wide range of retirement planning questions covering annuities and life insurance surrender charges, the financial impact of losing a spouse, Roth conversions as a hedge against the "widow's tax penalty," tax-loss harvesting through direct indexing, dividend reinvestment strategies in retirement accounts versus taxable accounts, HSA withdrawal rules after age 65, and appropriate cash allocations in retirement portfolios. Throughout the discussion, they emphasize the importance of tax planning, understanding how different retirement income strategies align with personal preferences, and avoiding one-size-fits-all approaches when managing retirement assets and income. Listen now to learn more! Takeaways Surrendering an annuity early can trigger surrender charges, while permanent life insurance policies often take many years before cash value exceeds premiums paid. The death of a spouse can create significant tax challenges because the surviving spouse typically moves from married filing jointly to single tax brackets. Roth conversions can be an effective strategy for reducing future RMD burdens and mitigating the "widow's tax penalty" for a surviving spouse. Direct indexing and tax-loss harvesting allow investors to capture losses while remaining invested, potentially creating future tax benefits and improving after-tax outcomes. Tax-loss harvesting is no longer just for ultra-high-net-worth investors, as technology has made these strategies more accessible and scalable. In IRA accounts, continuing to reinvest dividends during retirement generally remains the simplest and most efficient approach. In taxable brokerage accounts, turning off automatic dividend reinvestment can make rebalancing and distribution planning more tax-efficient. HSA funds can be used tax-free for qualified medical expenses at any age, while after age 65 non-qualified withdrawals avoid the 20% penalty but still incur income tax. Medicare Part B, Part C (Advantage), Part D premiums, and IRMAA surcharges can generally be reimbursed from an HSA, but Medigap premiums cannot. Holding 40% of a retirement portfolio in cash may be excessive when annual withdrawal needs are relatively low, and could indicate a mismatch between an investor's retirement income strategy and personal preferences. Chapters 00:00 Tax Considerations in Asset Sales 01:57 Understanding Life Insurance and Annuities 04:03 Financial Implications of Spousal Death 06:23 Roth Conversions and Widow's Penalty 07:36 Tax Loss Harvesting Strategies 17:12 Dividend Reinvestment in Retirement Accounts 22:48 Using HSA Distributions for Medical Expenses 25:52 Cash Reserves in Retirement Planning Links Looking for a retirement strategy that's actually built for you? Join Alex Murguia on July 1 at 1 PM ET for a FREE Retirement Researcher webinar, Are You Sure Your Retirement Strategy Fits?, where he'll walk through the four major retirement income approaches and show how the RISA® Framework can help you identify the strategy that best aligns with your goals, preferences, and vision for retirement. Register here: retirewithstyle.com/podcast
Federal retirement planning at 60: if you're a year or two from retiring from federal service with a FERS pension, Social Security, and about $1M saved in your TSP, here are 5 decisions to make before you retire — so you stop asking "Am I okay?" and start building the retirement you actually want.This covers income order, TSP taxes and RMDs, Roth conversions, FEHB and Medicare timing, and IRMAA — gaps many federal employees miss before retiring.Apply for a Retirement Consultation: https://perspectivefunnel.co/682642d22275ec003bfa6626/691df07396253e003c42b434/?ps_hello=THE 5 DECISIONSYour numbers look fine — but you still don't feel okay. That's the gap we're closing.1) Income order — You've got three engines: your FERS pension, Social Security, and TSP. The pension turns on the day you retire. Social Security has a filing window from 62 to 70 — thousands of dollars a month for life. TSP is the lever you control. The real question: which do you draw from first, and which do you let grow?2) Taxes & RMDs — Required minimum distributions start between age 73 and 75 (depending on your birth year) from your Traditional TSP, IRA, and 401(k). They land on top of your pension and Social Security, which can push you into a higher bracket in retirement. The years before then are your Roth conversion / sequencing window. And IRMAA is a real Medicare surcharge that hits about two years later.3) Healthcare — FEHB is gold and stays with you in retirement. Medicare enters at 65: do you take Part B, skip it, or coordinate with FEHB? Miss the enrollment window and there's a late-enrollment penalty. Decide before the deadline, not after.4) Investments — You're shifting from accumulation to distribution. The portfolio that got you here often isn't the one that should carry you through retirement. Rethink risk and your TSP fund mix so a bad market doesn't force you to sell at the wrong time.5) Purpose — Plan what you're retiring TO, not just what you're retiring from. We've seen federal employees retire with $1M and go back to work in six months — no Monday-morning plan. Money is half the equation; structure, identity, and what's on your calendar are the other half.WHAT TO DO THIS MONTH: Lock your exact retirement date. Run three tax pictures (year one, when Social Security starts, when TSP/IRA withdrawals begin — and how much to withhold). Map your income order. Make the FEHB + Medicare call early. Write down your first 90 days on a calendar, not a spreadsheet. Do it intentionally, not perfectly.CHAPTERS0:00 Age 60, a Federal Pension, and $1M Saved — What Comes Next?0:27 Your Numbers Look Fine but Still Feel Unclear0:38 Decision 1 — Your Federal Retirement Income Order (Pension, SS, TSP)1:46 Decision 2 — TSP Taxes, RMDs, Roth Conversions & IRMAA2:46 Decision 3 — FEHB, Medicare Part B & Healthcare Timing3:34 Decision 4 — Shifting From Accumulation to Distribution5:38 Decision 5 — Planning What You're Retiring To6:19 What to Do This Month Before You Retire6:42 Apply for a Federal Retirement ConsultationMORE RESOURCESFederal Retirement Guidebook: https://cdfinancial.org/being-a-federal-employee-book/Take the Checklist Challenge: https://cdfinancial.org/checklist-challenge/Weekly Federal Retirement Planning Newsletter: https://cdfinancial.com/newsletterOPM Retirement Center: https://www.opm.gov/retirement-center/OPM FERS Information: https://www.opm.gov/retirement-center/fers-information/Social Security Full Retirement Age: https://www.ssa.gov/retirement/full-retirement-ageMedicare Late Enrollment Penalties: https://www.medicare.gov/basics/costs/medicare-costs/avoid-penaltiesWHO WE ARECD Financial helps federal employees and retirees make smarter retirement decisions around FERS, TSP, FEHB, Medicare, survivor benefits, and retirement income planning. Our mission: help federal employees retire with more clarity, confidence, and peace of mind. Subscribe for practical federal retirement planning content designed to help you understand your benefits, avoid common planning gaps, and prepare for your next chapter.DISCLAIMERThis video is for educational purposes only and is not financial, legal, tax, healthcare, or investment advice. Federal retirement decisions depend on your individual service history, agency records, health coverage, survivor needs, income goals, and personal circumstances. Always consult qualified professionals and review official OPM guidance before making retirement elections.Advisory services are offered through CD Financial LLC dba CD Financial, an Investment Adviser in the State of California. Insurance products and services are offered through CD Financial & Insurance Services LLC, an affiliated company. Opinions expressed are solely those of CD Financial. Information herein is derived from sources believed to be reliable but is not guaranteed as to accuracy or completeness.#FederalRetirement #FERSRetirement #FederalEmployees #RetirementPlanningSupport the show
Summary Most people know Medicare costs money in retirement, but few understand how much their income level affects what they actually pay. In this episode, Wade Borth unpacks IRMAA, the income-related surcharge that can quietly add $162 to $650 or more per month to your Medicare premiums, depending on what you earn. Wade walks through who gets hit, what counts as income in the calculation (including surprises like municipal bond interest and Social Security), and how a single dollar over the threshold can cost you hundreds of thousands of dollars over time. He also explains how properly structured whole life insurance creates an income stream that falls outside the IRMAA calculation, giving retirees a meaningful planning advantage. Key Takeaways IRMAA can add hundreds of dollars per month to Medicare premiums, and a single dollar over the income threshold triggers the full surcharge with no gradual phase-in. Every dollar of the surcharge has a compounding cost. That extra $162 per month, grown at 4% over 20 years, is worth nearly $60,000 in real wealth. Income sources many people overlook in the IRMAA calculation include capital gains, Social Security income, municipal bond interest, rental income, and Roth conversions. IRMAA looks back two years, so a one-time income spike follows you into retirement longer than most people expect. Properly structured whole life insurance, when funded correctly, provides an income stream through policy loans that does not count toward the IRMAA calculation, giving retirees real choices when managing retirement income. Links and Resources Sage Wealth Strategy: sagewealthstrategy.com Keywords IRMAA, Medicare premiums, income-related monthly adjustment amount, retirement planning, Medicare Part B, Medicare Part D, retirement income, whole life insurance, infinite banking concept, IBC, policy loans, capital gains in retirement, Roth IRA withdrawals, 401k withdrawals, Medicare surcharge, retirement mistakes, Wade Borth, Sage Wealth Strategy, wealth erosion retirement, family banking Episode Highlights [00:00:00 - 00:01:32] Wade opens with a lunch conversation where a friend approaching retirement had no idea how IRMAA would affect his Medicare costs. [00:05:15 - 00:08:17] Wade explains the $218,000 joint income threshold and how IRMAA brackets step up in full increments, not gradually. [00:08:18 - 00:09:21] One dollar over the threshold adds $162 per month to a couple's Medicare premium, a 40 percent increase with no phase-in. [00:09:22 - 00:12:24] At a 4 percent growth rate, that extra $162 per month is worth $60,000 over 20 years. At the top bracket, the 20-year cost reaches $238,000. [00:12:25 - 00:17:03] Wade walks through every income source factored into the IRMAA calculation, including capital gains, Social Security, municipal bond interest, and Roth conversions. [00:17:04 - 00:19:35] HSA distributions and Roth IRA withdrawals do not count toward IRMAA, creating real planning flexibility for retirees who hold these assets. [00:19:36 - 00:23:46] Properly structured whole life insurance policy loans fall outside the IRMAA calculation, giving retirees an income source they can draw from without triggering the surcharge.
Apply for a Retirement Consultation:https://perspectivefunnel.co/682642d22275ec003bfa6626/691df07396253e003c42b434/?ps_hello=%20Get the Digital Federal Retirement Guidebook:https://cdfinancial.org/being-a-federal-employee-in-the-era-of-trump-book/Take the Checklist Challenge:https://cdfinancial.org/checklist-challenge/Subscribe for Weekly Federal Retirement Planning Content:https://cdfinancial.com/newsletterYou're 60, you have a federal pension and $1M saved — so why doesn't it feel like enough? The answer is 5 unmade decisions, not more dollars.If you are within a year or two of leaving federal service with a FERS pension and a healthy TSP balance, this is the time to stop asking "Am I okay?" and start asking "Have I decided?" In this video, Charles and Marcus break down the 5 Decisions Framework federal employees should work through before finalizing retirement: income order, taxes and RMDs, healthcare, investments, and purpose.Whether you are trying to decide when to file for Social Security, how to manage the tax window before RMDs begin at 73, or how FEHB and Medicare Part B fit together, this episode walks through the planning areas many federal employees overlook — including the two decisions that have nothing to do with a spreadsheet.━━━━━━━━━━━━━━━FEDERAL RETIREMENT RESOURCES━━━━━━━━━━━━━━━OPM Retirement Center:https://www.opm.gov/retirement-center/Social Security Delayed Retirement Credits:https://www.ssa.gov/benefits/retirement/planner/delayret.html━━━━━━━━━━━━━━━TIMESTAMPS━━━━━━━━━━━━━━━0:00 Age 60 With a Federal Pension and $1M — Am I Okay?2:00 Why "Am I Okay?" Is the Wrong Question3:00 Decision 1: Income Order — Pension, Social Security, or TSP First?5:30 Decision 2: Taxes & RMDs — The Age 73 Cliff and Your Tax Window7:30 Decision 3: Healthcare — FEHB + Medicare Part B9:30 The Two Decisions That Aren't About Money10:00 Decision 4: Investments — From Accumulation to Distribution12:00 Decision 5: Purpose — The Tuesday at 10 AM Test14:00 What to Do This Month If Retirement Is Approaching16:30 "Have I Decided?" — The Real Question18:30 How to Get Answers for Your Specific Situation━━━━━━━━━━━━━━━WHO WE ARE━━━━━━━━━━━━━━━CD Financial helps federal employees and retirees make smarter retirement decisions around FERS, TSP, FEHB, Medicare, survivor benefits, retirement income planning, and health-focused financial strategies.Our mission is simple:Help federal employees retire with more clarity, confidence, and peace of mind.Subscribe for practical federal retirement planning content designed to help you better understand your benefits, avoid common planning gaps, and prepare for your next chapter with confidence.━━━━━━━━━━━━━━━IMPORTANT DISCLAIMER━━━━━━━━━━━━━━━Advisory services are offered through CD Financial LLC dba CD Financial, an Investment Advisor in the State of California. Insurance products and services are offered through CD Financial & Insurance Services LLC, an affiliated company.This video is for educational purposes only and should not be considered financial, legal, tax, healthcare, or investment advice. Federal retirement decisions depend on your individual service history, agency records, health coverage, survivor needs, retirement income goals, and personal circumstances. Always consult qualified professionals and review official OPM guidance before making retirement elections.Opinions expressed herein are solely those of CD Financial and our editorial staff. The information contained in this material has been derived from sources believed to be reliable but is not guaranteed as to accuracy or completeness and does not purport to be a complete analysis of the materials discussed. All information and ideas should be discussed in detail with your individual adviser prior to implementation.retire at 60 federal employee, federal pension and TSP retirement, FERS retirement at 60, can I retire with 1 million and a pension, TSP withdrawal strategy, when to take Social Security federal employee, RMD age 73, Roth conversion before RMDs, FEHB and Medicare Part B, IRMAA surcharge, sequence of returns risk, retirement income order, federal retirement planning#federalretirement #FERS #retirement #TSP #federalemployees #retirementsavings #governmentemployee #RetireAt60 #FederalPension #CDFinancialSupport the show
Apply for a Retirement Consultation:https://perspectivefunnel.co/682642d22275ec003bfa6626/691df07396253e003c42b434/?ps_hello=%20Get the Digital Federal Retirement Guidebook:https://cdfinancial.org/being-a-federal-employee-in-the-era-of-trump-book/Take the Checklist Challenge:https://cdfinancial.org/checklist-challenge/Subscribe for Weekly Federal Retirement Planning Content:https://cdfinancial.com/newsletterRetiring This Year? Federal Employees Need More Than a TSP PlanIf you are planning to retire this year as a federal employee, your retirement decision may involve more than your TSP balance. Your FERS pension, TSP income strategy, Social Security timing, and FEHB health coverage all work together, and getting the order wrong can create costly planning gaps.In this video, we break down the 4-lane federal retirement roadmap for employees in their final year before retirement. You will learn why generic retirement advice often fails federal employees, what to verify before signing retirement paperwork, and why health insurance, survivor benefits, and Social Security should not be treated as separate decisions.Whether you are trying to choose your retirement date, protect your spouse, create reliable TSP income, or avoid common FEHB and Medicare mistakes, this episode walks through the planning areas many federal employees overlook.IN THIS VIDEO YOU CAN LEARNWhy federal retirement planning is different from private-sector retirement adviceHow your FERS pension, TSP, Social Security, and FEHB all connectWhy your retirement date can affect your pension, annual leave payout, unused sick leave credit, and potential FERS supplementHow to verify your service computation date and creditable federal serviceWhy military buyback can matter before you retireAnd more━━━━━━━━━━━━━━━FEDERAL RETIREMENT RESOURCES━━━━━━━━━━━━━━━OPM Retirement Center:https://www.opm.gov/retirement-center/OPM FEHB Program:https://www.opm.gov/healthcare-insurance/healthcare/Thrift Savings Plan:https://www.tsp.gov/Social Security Retirement Planner:https://www.ssa.gov/retirementTIMESTAMPS00:00 Retiring This Year as a Federal Employee01:06 Why Generic Retirement Advice Fails Federal Employees02:27 The 4-Lane Federal Retirement Roadmap04:54 Common Federal Retirement Roadblocks07:55 TSP Income Planning and Long-Term Strategy08:26 Survivor Benefits, Spouse Conversations, and Health Coverage10:00 Social Security Timing Mistakes for Federal Employees11:26 Retirement Date, Sick Leave, and Annual Leave Planning13:42 FEHB, Medicare Part B, and Survivor Benefit Coordination16:58 First Steps to Take If You Are One Year From Retirement19:03 Why Sequencing Your Retirement Decisions Matters21:45 Final Checklist and Next StepWHO WE ARECD Financial helps federal employees and retirees make smarter retirement decisions around FERS, TSP, FEHB, Medicare, survivor benefits, retirement income planning, and health-focused financial strategies.Our mission is simple:Help federal employees retire with more clarity, confidence, and peace of mind.Subscribe for practical federal retirement planning content designed to help you better understand your benefits, avoid common planning gaps, and prepare for your next chapter with confidence.IMPORTANT DISCLAIMERAdvisory services are offered through CD Financial LLC dba CD Financial, an Investment Advisor in the State of California. Insurance products and services are offered through CD Financial & Insurance Services LLC, an affiliated company.This video is for educational purposes only and should not be considered financial, legal, tax, healthcare, or investment advice. Federal retirement decisions depend on your individual service history, agency records, health coverage, survivor needs, retirement income goals, and personal circumstances. Always consult qualified professionals and review official OPM guidance before making retirement elections.Opinions expressed herein are solely those of CD Financial and our editorial staff. The information contained in this material has been derived from sources believed to be reliable but is not guaranteed as to accuracy or completeness and does not purport to be a complete analysis of the materials discussed. All information and ideas should be discussed in detail with your individual adviser prior to implementation.Federal retirement planning, FERS retirement, retire this year, federal employee retirement, TSP retirement income, FEHB in retirement, Social Security timing, FERS pension, high-3 average salary, service computation date, military buyback, survivor benefit, Medicare Part B, federal retirement checklist, OPM retirement, federal employee benefits, retirement income planningSupport the show
Retirement planning extends well beyond simply saving enough during your working years—it plays out with every decision you make once you stop working. One crucial, sometimes overlooked, aspect is managing Required Minimum Distributions (RMDs) from your retirement accounts. If you have a retirement account approaching your RMD age, this episode breaks down the essential rules based on your birth year, how to calculate your distribution using the IRS tables, and key tax implications to keep in mind. You'll also get actionable tips to help minimize your future RMDs, from optimizing your income plan and leveraging Roth conversions to using qualified charitable distributions. You will want to hear this episode if you are interested in... [00:00] RMD rules and calculations [05:10] RMDs and distribution timing [09:03] Retirement accounts and RMD rules [14:22] Tax strategies for retirement planning [17:00] Common RMD mistakes and solutions [19:21] Proper charitable distribution process What Are Required Minimum Distributions (RMDs)? RMDs are the minimum amounts you must withdraw annually from certain retirement accounts starting at a specific age, as mandated by the IRS. These distributions apply to traditional IRAs, rollover IRAs, SIMPLE IRAs, SEP IRAs, 401(k)s, 403(b)s, 457 plans, and profit-sharing plans. Importantly, Roth IRAs and Roth 401(k)s are exempt from RMDs, and regular taxable investment accounts are not impacted. The required age for beginning RMDs now depends on your birth year: If you were born between January 1, 1951, and December 31, 1959, RMDs start at age 73. If born on January 1, 1960, or later, RMDs begin at age 75. Tax Implications of RMDs RMDs are taxed as ordinary income. If you're not careful, withdrawals can bump you into a higher tax bracket, increase how much of your Social Security is taxable, or trigger additional Medicare Part B and Part D premiums due to IRMAA. Failing to withdraw the required amount carries a steep penalty—25%, reduced to 10% if corrected within two years. Strategies to Lower Your RMDs Don't put all your savings in pre-tax accounts. Split between traditional and Roth accounts or invest some in taxable brokerage accounts, which aren't subject to RMDs. It can be useful to collaborate with a financial advisor to create a withdrawal strategy that minimizes taxes by pulling funds strategically from different account types. You can also convert portions of your pre-tax accounts to Roth IRAs in years when your income (and tax bracket) is lower, helping "fill the bucket" at the lowest rates. If you retire early, delaying Social Security until age 70 increases your benefit and can create years of low taxable income—perfect for executing Roth conversions. If you're 70½ or older, you can also donate up to $100,000 per year directly from your IRA to a qualified charity. These gifts count toward your RMD but are excluded from taxable income. Enjoying a Comfortable Retirement Navigating RMDs isn't just about following IRS rules—it's an ongoing strategy to keep your taxes low and your retirement income steady. By understanding your obligations and using the available tools, you can maximize your retirement savings and create a more secure future. Resources Mentioned Retirement Readiness Review Subscribe to the Retire with Ryan YouTube Channel Download my entire book for FREE Connect With Morrissey Wealth Management www.MorrisseyWealthManagement.com/contact Subscribe to Retire With Ryan
Hospitals already have felt some of the effects of the Inflation Reduction Act on 340B savings, but with the IRA set to expand to more drugs in 2027, hospitals also are starting to project how it might affect their bottom lines next year. 340B Vice President of Pharmacy Services and Education Steven Miller joins us to explain how hospitals can be making those projections now.The IRA Will Expand to Another 15 DrugsNext year, an additional 15 drugs will be subject to Medicare price caps under Medicare Part D on top of the 10 drugs that saw caps this year. Steve says this will cut into 340B savings and overall margins even more — with some 340B discounts possibly dropping to their statutory minimums. These reductions also will translate to commercial and cash-pay dispenses, changing the overall financial outlook for hospitals.Hospitals Cannot Rely on Current 340B Savings Levels for 2027Steve says the 2027 changes are key for future budgeting. If hospitals do not adjust how they are budgeting for 340B drugs subject to Medicare price caps, they are likely to be short on their budget projections. He strongly recommends 340B teams have important conversations with finance teams now about how the IRA will affect their hospital or health system next year.Hospitals Can Be Planning NowFor the rest of 2026, Steve recommends hospitals monitor list pricing and 340B ceiling pricing regularly and to increase monitoring of purchases overall, given how drugmaker pricing behavior affects future 340B prices and savings. As the IRA continues to broaden over the next several years, including to Medicare Part B dispenses, he also recommends hospitals consider securing funding or support from other areas for any 340B-funded services that might see negative IRA impacts.Resources:Prepare Your Leadership for 340B Changes From 2027 Medicare Drug Price Caps
Apply for a Retirement Consultation: https://perspectivefunnel.co/682642d22275ec003bfa6626/691df07396253e003c42b434/?ps_hello=%20
Get the digital book at no cost to you here: https://cdfinancial.org/being-a-federal-employee-in-the-era-of-trump-book/Want to work with Charles? Apply here: https://cdfinancial.org/schedule-a-meeting/Checklist Challenge: https://cdfinancial.org/checklist-challenge/Newsletter: https://cdfinancial.com/newsletterWHO ARE WE?CD Financial helps federal employees and near-retirees create sustainable, tax-smart retirement income. Expect weekly strategies on 401K, FERS, TSP, Social Security timing, tax planning, and health-meets-wealth habits—clear, practical, compliant.TIMESTAMPS0:00 Last Year Before Federal Retirement Checklist0:22 Two Federal Employees, Two Different Retirement Outcomes0:46 Sick Leave Credit and Common FERS Retirement Mistakes1:08 How to Review and Potentially Improve Your Federal Pension1:43 Retirement Date Considerations for Federal Employees2:12 FEHB, Medicare Part B, and Retirement Healthcare Decisions3:13 Survivor Benefit Elections for Federal Employees3:50 Free Federal Retirement Checklist and Next Steps#FederalRetirement #FERSRetirement #FederalEmployees #RetirementChecklist #CDFinancialAdvisory services are offered through CD Financial LLC dba CD Financial, an Investment Advisor in the State of California. Insurance products and services are offered through CD Financial & Insurance Services LLC, an affiliated company.Opinions expressed herein are solely those of CD Financial and our editorial staff. The information contained in this material has been derived from sources believed to be reliable but is not guaranteed as to accuracy and completeness and does not purport to be a complete analysis of the materials discussed. All information and ideas should be discussed in detail with your individual adviser prior to implementation.Support the show
What does it mean to retire in 2026, and how does today's retirement landscape differ from 10 or 20 years ago? With more retirees facing challenges such as rising healthcare costs, higher cost of living, concerns about Social Security, shifting demographics, and the impacts of national debt, this episode digs into the current risks and opportunities for those planning their golden years. I share insights from a recent Goldman Sachs retirement study and answer listener questions on retirement planning software, investment strategy before retirement, handling 401(k) and IRA loans, and Social Security rules for working retirees. You will want to hear this episode if you are interested in... [00:00] Retirement planning in 2026 [06:28] Current market conditions and challenges [10:31] Rising health insurance costs [14:24] Financial strain on parents supporting kids [18:48] Concerns about retirement taxes [23:21] Preparing for financial downturns [28:20] Understanding 401 (k) and IRA loans [32:35] Social Security benefits and retirement planning [37:23] Understanding annuities and IRA conversions Inflation and the Cost of Living One of the biggest concerns voiced by pre-retirees is how much more expensive life has become. The past decade, especially following COVID-19, has seen inflation spike well above its historical average. Not only are day-to-day essentials like groceries and gas more costly, but so too are the experiences retirees often look forward to—such as travel and dining out. With airline tickets and fuel prices high, the cost of enjoying retirement can quickly outpace what many planned for just a few years ago. Healthcare: An Ever-Increasing Expense Another major pain point is the skyrocketing cost of healthcare. Medicare premiums have jumped (with Medicare Part B premiums alone increasing by over 9% in one year recently), and pre-Medicare retirees face especially steep coverage costs. Whether paying directly, dealing with COBRA, or navigating the healthcare exchange, retirees must factor in the rising cost of both routine and unpredictable medical needs, which eat into savings at a faster rate. Social Security and Family Support With millions of Baby Boomers now collecting benefits and the youngest Boomers becoming eligible, there is increased pressure on the system. There are some very real concerns about funding gaps and the likelihood that Congress will have to make difficult decisions soon to ensure benefits remain viable for future generations. Retirement planning is now more deeply intertwined with broader demographic changes. People are waiting longer to marry, buy homes, and start families—all of which impact when and how retirees are called upon to support children and grandchildren. Whether contributing to down payments, funding weddings, or assisting with fertility treatments and adoptions, modern retirees often find their savings supporting family milestones happening later in life. National Debt and Tax Policy Government debt is at record highs, surpassing $39 trillion, and this raises serious questions about future tax rates. Retirees must plan for the possibility that taxes will increase, which could impact how much of their savings they'll have available for spending. Retirement in 2026 and beyond is both promising (with record numbers of millionaires) and uniquely challenging. By understanding these new realities, today's retirees can build a plan that provides peace of mind and the freedom to enjoy life's next chapter. Resources & People Mentioned 3 Steps to Retirement Planning Goldman Sachs Retirement and Insights Survey Connect With Gregg Gonzalez Email at: Gregg.gonzalez@lpl.com Podcast: https://RetireStrongFA.com/Podcast Website: https://RetireStrongFA.com/ Follow Gregg on LinkedIn Follow Gregg on Facebook Follow Gregg on YouTube Subscribe to Retirement Made Easy On Apple Podcasts, Spotify, Google Podcasts
Many retirees assume their Medicare premiums will stay consistent once they enroll. But that's not always the case, especially for higher-income individuals. In this episode, Larry Heller, CFP®, CDFA®, breaks down IRMAA, the income-related surcharge that can increase your Medicare Part B and Part D premiums based on income from two years prior. He explains how everyday financial decisions, from IRA withdrawals to capital gains and Roth conversions, can unexpectedly push you into higher premium brackets. Larry discusses: What IRMAA is and how it impacts Medicare premiums How income from two years prior determines your current costs Common triggers like Roth conversions, property sales, and large withdrawals Strategies to potentially reduce IRMAA through proactive tax and income planning Why coordinating tax, investment, and healthcare decisions is essential in retirement And more! Resources: SSA Form 44 (to report a life-changing event and potentially reduce IRMAA) Medicare IRMAA income brackets and thresholds Connect with Larry Heller: (631) 248-3600 Schedule a 20-Minute Call Heller Wealth Management LinkedIn: Larry Heller, CFP®, CDFA®, CPA YouTube: Retirement Unlocked with Larry Heller, CFP® Heller Wealth Management is now part of Savant Wealth Management. Savant is a Registered Investment Advisor. This content is provided for informational and educational purposes only and should not be construed as personalized investment advice. Effective March 31, 2026, Heller Wealth Management joined Savant Wealth Management (“Savant”). A copy of Savant's current written disclosure Brochure discussing our advisory services and fees is available at www.savantwealth.com/disclosure-brochures/
Toni talks about Medicare Forms CMS-1763 and outlines the proper, most efficient way to disenroll in Medicare. Look for the Medicare Road Map and How To Enroll in Medicare on Toni's website: www.tonisays.com Questions? Call Toni at 832-519-8664, write: info@tonisays.com And Yes, Medicare Fraud is Real! www.Medicare.gov is the website where you can check claims against your Medicare account Medicare's telephone number: 800-633-4227 - Please call if you suspect that your account has been subject to fraud. Visit www.gracealley.com and receive a 10% discount when ordering an American flag, or the new America 250 flag or anything on the website using the code tonisays10 at checkout! Happy Birthday America! Toni's new Medicare Survival Guide Advanced Edition book is available now - pick up your copy at www.tonisays.com Want more information? Take advantage of Toni's brand new video series now a available at https://tonisays.com Remember - with Medicare it's what you don't know that will hurt you! There's so much good information in this podcast, please be sure to share this podcast with your friends! Recognized by feedspot.com as one of the best Medicare Podcasts in the nation! Write Toni - info@tonisays.com. Toni's book is available at www.seniorresource.com and https://tonisays.com You can call Toni at 832-519-8664 Toni welcomes all Medicare questions. Toni now offers informative Medicare Webinars for all of your Medicare needs at https://tonisays.com You can find Medicare Moments wherever you find your favorite podcasts, such as: Apple: https://apple.co/44MoguG Spotify: https://open.spotify.com/show/7c82BS4hb145GiVYfnIRsoAmazon Music: https://music.amazon.com/podcasts/884c1f46-9905-4b29-a97a-1a164c97546b/medicare-moments?refMarker=null You can find Medicare Moments at: https://podcasts.seniorresource.com/medicare-moments/ Toni's new book: Maze of Medicare is now available at www.tonisays.com Combining Scripture with Medicare, it is the only book of its kind. Toni's columns appear weekly in about 100 newspapers across America. If you would like Toni's column to appear in your local paper, or if you would like Toni to speak at an event - contact Toni King at 832-519-8664 Thank you for listening and be sure to tell your friends about Medicare Moments! Blessings! Toni KingSee omnystudio.com/listener for privacy information.
More regulators are concerned about private credit The bad news just keeps coming for the private credit industry. If you're not sure what private credit is, it is mostly middle market business loans extended by asset managers. People often don't realize that these asset managers don't have the same strict supervision that banks have on their loans. Investors may be starting to realize the risk because in the first quarter of 2026, private credit investors requested $20 billion from some of the private credit funds. Unfortunately, they only got a little bit over 50% of what they requested or about $11 billion. This could lead to higher redemption requests above $20 billion in the second quarter as more investors become disenchanted with private loan funds. The Securities Exchange Commission over the past few months has opened several enforcement investigations of large private credit managers. The Treasury department is also requesting information from private fund managers and insurance firms to understand their businesses more. The Securities Exchange Commission is the primary regulator for the private credit industry, but the private funds don't regularly disclose holdings and don't reveal much about private credit on the forms that are used by the SEC. It is quite the dilemma for these private credit funds, and I do believe it will continue to get worse because I am confident that the SEC and the Treasury department will find areas that could really hurt the individual investor due to the lack of disclosures. Could prediction markets be available in your IRA soon? Bitwise, Roundhill, and GraniteShares have filed applications with the SEC to launch exchange-traded funds tied to event contracts. If approved, these products could potentially be held in self-directed IRAs. The initial proposals appear relatively narrow in scope, focusing on outcomes like which party wins the White House in 2028 and which party controls the House and Senate after this year's midterm elections. While these types of products can sound appealing—and successful bets could generate strong returns—they also carry a clear risk: if you're wrong, you lose your entire investment. One of the main concerns is how complex and speculative these instruments are, especially in the context of retirement accounts. Event contracts are fundamentally different from traditional investments like stocks or bonds, and their all-or-nothing nature makes them more like betting rather than than long-term investing. Are we going to soon allow withdrawals from retirement assets in Vegas so people can blay blackjack? The odds may be better there than on some of these “event contracts.” There are also broader legal and regulatory questions still being debated. Some states argue that certain event contracts—particularly those tied to sports outcomes—should be classified as sports gambling, which would place them under state jurisdiction rather than the Commodity Futures Trading Commission. Tribal groups have also raised concerns, arguing that such products could infringe on their sovereign rights to regulate gambling on tribal lands. At the moment, sports-related event contract ETFs are not part of these filings, but that could evolve depending on how the legal landscape develops. If courts ultimately allow these types of products and current applications move forward, it's possible that similar filings tied to sports outcomes could follow. Regardless of how regulation unfolds, it's important to understand the nature of these products. While they may be packaged as ETFs, their structure and risk profile differ significantly from traditional investments. Anyone considering them should be clear on one point: this is not investing in the conventional sense—it's a high-risk, all-or-nothing proposition that is really just gambling. Who offers a better reward program? The big gas stations or Costco? When I pull into a Shell gas station, I always see a pitch on the screen about getting up to $0.30 back per gallon. Other stations like Chevron run similar promos, which got me wondering: how many people actually sign up—and are these deals better than Costco's credit card with 4% cashback on gas? Right off the bat, gas station rewards programs feel overly complicated. Once you dig in, you'll find caps, conditions, and purchase limits that make it tough to consistently get the maximum benefit. In the best-case scenario, you might get around $0.35 off per gallon. If gas is $6 per gallon, that works out to roughly a 5.8% discount. Not bad—but actually hitting that number regularly is another story. Costco's credit card, on the other hand, offers a straightforward 5% cashback at Costco gas stations and 4% cashback at other gas stations (up to $7,000 per year). At $6 per gallon, that's about $0.24 back per gallon; at $5 per gallon, it's $0.20. To hit the annual cap, you'd need to buy around 22.4 gallons per week at $6 per gallon, or about 26.9 gallons per week at $5. If you're filling up at a Costco station, the math can tilt even more in your favor. Gas there is often $0.10–$0.30 cheaper per gallon to begin with. Pair that with 5% cashback, and your effective savings climb even further: about $0.25 per gallon at $5 gas, or $0.30 at $6. So, when you're standing at the pump at Shell or Chevron and see an offer for a flashy rewards program, it's worth pausing. The headline numbers can look appealing, but the real-world value often depends on how much you drive and how closely you follow the program's rules. For many people, a simple, consistent cashback card—especially one tied to already lower fuel prices—may end up being the better, less stressful option. Is there a bubble in sports teams? We've spent plenty of time talking about stretched valuations in stocks, the frenzy in crypto, and the rise of prediction markets—but sports teams may deserve a spot in that conversation too. Valuations across major leagues are climbing at a remarkable pace. The NFL is leading the charge, with the average team now valued at $7.65 billion, up from roughly $1 billion in 2010. NBA franchises tell a similar story: the average team is worth $5.52 billion, an 18% jump from just last year. Go back 15 years, and the average NBA team was valued around $369 million—an increase of 1,396%. By comparison, the S&P 500's roughly 425% return over that same period looks modest. Major League Baseball is seeing it too, with the San Diego Padres reportedly finalizing a record sale at $3.9 billion. As prices climb, fewer buyers can afford entry into the top leagues, pushing capital into smaller or emerging sports that may carry more risk. Rick Horrow, CEO of Horrow Sports Ventures, highlighted this trend: “Major League Cricket was at $5 million. Now the value's at $30 million and going higher. Major League Pickleball two years ago was at $5 million. Now the value is at $15 million or higher.” Women's sports are also experiencing rapid growth. The National Women's Soccer League recently awarded an expansion franchise in Columbus, Ohio for $205 million—a $40 million increase over the fee paid by Arthur Blank (The Falcon's owner) for Atlanta's team in November. That deal itself was a sharp jump from the $110 million paid by Denver in January of last year. For perspective, expansion fees were around $2 million as recently as 2022. The key question is whether these valuations are supported by underlying fundamentals. While interest is rising—about 1.2 million people watched the NWSL final, up 22% year over year—it still trails far behind the audiences of major leagues. Game 7 of the NBA Finals drew 16.4 million viewers, the World Series drew 25.9 million, and the Super Bowl surpassed 127 million. Media rights are central to this dynamic. The NFL signed an 11-year, $111 billion deal in 2021 and is already eyeing further increases. The NBA followed with its own 11-year, $77 billion agreement starting in 2025. If these massive contracts continue to absorb the bulk of media spending, smaller leagues may struggle to sustain their current growth trajectories. Most people will never be in a position to buy a sports franchise, but the broader trend is still worth watching and I believe is just yet another example of excessive valuations in today's markets. Financial Planning: Understanding the Relative Cost of IRMAA IRMAA (Income-Related Monthly Adjustment Amount) is best understood not as a flat cost, but as an additional marginal tax rate layered on top of federal and state income taxes. When your income exceeds certain thresholds, your Medicare Part B and Part D premiums increase, and because the adjustment applies for the entire year once you cross the threshold, even by $1, it creates a “tax cliff.” For example, in 2026 the first IRMAA tier for married couples begins at $218,000 of income. At that point, Part B premiums increase from $202.90 to $284.10 and Part D increases $14.50, resulting in an additional annual cost of $2,296.80. Since this tier spans $56,000 of income (from $218,000 to $274,000), that cost translates to roughly a 4.1% marginal “tax” on income within that range, but only if you fully utilize the entire bracket. If you only exceed the threshold by a small amount, you still incur the full $2,296.80 cost, which means the effective marginal rate on those extra dollars can be extremely high. When layered on top of a 22% federal bracket and 9.3% California tax rate, the true marginal rate is about 35.4% if the bracket is filled, but can be significantly higher if it is not. This framing is critical when evaluating strategies like Roth conversions or large withdrawals, because it highlights that the decision isn't just about stated tax brackets, it's about the all-in marginal rate including IRMAA. In practice, this means it is often beneficial to either stay below an IRMAA threshold or intentionally “fill up” the bracket once crossed, ensuring the additional premium cost is spread across the full income range rather than concentrated on just a few dollars. Companies Discussed: Tractor Supply Company (TSCO), Intel Corporation (INTC) & The Procter & Gamble Company (PG)
This week's theme on the Retirement Quick Tips podcast is The Hidden Tax Traps in RetirementToday, I'm talking about IRMAA (Income-Related Monthly Adjustment Amount). It's an additional surcharge added to Medicare Part B and Part D premiums if you have higher income. IF you're single, IRMAA kicks in above $109k in income. If you're married, it kicks in above $218 of income.
If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: https://www.eseniorinsurance.com✅ Call us: (801) 255-5340
Retirement planning can feel overwhelming, but understanding key benefits and strategies can help you make the most of your financial future. On the show this week, I tackle listener questions on Health Savings Accounts (HSAs), Flexible Spending Accounts (FSAs), and Social Security. If you're considering an HSA, are curious about contribution limits, or want to know how HSAs can work alongside FSAs, I break it down in simple, clear language. I also answer a wide range of Social Security questions, and discuss how your benefits are calculated, timing your claim, navigating survivor benefits, and how to avoid costly mistakes during retirement. You will want to hear this episode if you are interested in... 03:44 HSA vs. FSA & social security 09:12 HSA and the triple tax advantage 16:38 "HSA vs. FSA explained 21:02 Early retirement social security adjustments 26:45 IRMAA Surcharges and Roth Conversions 30:00 Social security claim rules 37:09 Social security benefits strategy 38:36 Social security survivor benefits 44:45 Understanding social security earnings & inflation The Power of Health Savings Accounts HSAs stand out because contributions are tax-deductible, invested money grows tax-free, and withdrawals for qualified medical expenses are also tax-free. Unlike IRAs or 401(k)s, there are no required minimum distributions (RMDs), making them an appealing vehicle for long-term savings. Contributions via payroll deductions also avoid Social Security and Medicare taxes, enhancing their tax efficiency. HSAs are often misunderstood or underused, but they offer some of the most attractive tax benefits for medical expenses in retirement. To qualify, you must be enrolled in a high-deductible health plan. The latest contribution limits for 2026 are $4,400 for individuals and $8,750 for families, with a $1,000 catch-up for those 55 and older. Interestingly, the catch-up for HSAs starts at 55, unlike the 401(k) catch-up, which begins at 50. HSAs vs. FSAs: What's the Difference? Flexible Spending Accounts (FSAs) often get confused with HSAs, but they are fundamentally different. FSAs are a "use it or lose it" account, meaning funds must be spent within the plan year or risk forfeiture. HSAs roll over year to year and can accumulate significant balances for future health expenses and even long-term care. HSAs also have more flexible investment options and ownership, making them superior for many long-term planners. Navigating Social Security Statements, Timing, and Benefits Social Security's rules and estimates can be confusing. Your Social Security statement provides estimates based on the assumption you'll continue working at your current salary until retirement. If you retire early, these estimates adjust, but they don't include cost-of-living increases or Medicare Part B premiums, which will come directly out of your benefit. Many retirees are surprised to find their actual monthly check is lower than expected due to these deductions. One major factor is IRMAA (Income-Related Monthly Adjustment Amount), which increases Medicare premiums for higher-income retirees, based on income from two years prior. However, you can request an exception if your income drops due to retirement, using the SSA-44 form. Timing your claim is important. Social Security is typically a month or two behind when benefits start, so plan accordingly. Earned income before claiming does not count toward the annual limits; only income earned after starting benefits does. Spousal income also doesn't affect your individual Social Security benefit. Strategy Matters Retirement planning goes beyond just saving—it's about making strategic decisions for your health, income, and legacy. HSAs, Social Security, and FSAs all have unique rules that affect how you can maximize their benefits. Take time to understand how these accounts work, and don't be afraid to seek expert advice for your unique situation. Resources & People Mentioned 3 Steps to Retirement Planning Connect With Gregg Gonzalez Email at: Gregg.gonzalez@lpl.com Podcast: https://RetireStrongFA.com/Podcast Website: https://RetireStrongFA.com/ Follow Gregg on LinkedIn Follow Gregg on Facebook Follow Gregg on YouTube Subscribe to Retirement Made Easy On Apple Podcasts, Spotify, Google Podcasts
In Episode 130 of DC EKG, Joe Grogan sits down with Ryan Long to unpack two policy stories that are driving real-world drug costs and healthcare spending: the 340B program and the fallout from Medicare Part D changes under the Inflation Reduction Act. Ryan explains why the current 340B structure can incentivize higher costs, hospital consolidation, and contract pharmacy expansion, while often directing the biggest windfalls toward larger, wealthier systems rather than truly resource-constrained hospitals. They cover contract pharmacies, exposure to diversion and fraud, Medicare Part B reimbursement dynamics, and why reforms need to address the incentives baked into the program. They then turn to Medicare Part D, the shift from copays to coinsurance, premium pressure, the accelerated move into “catastrophic” coverage, and what happens when Washington promises savings that do not materialize. The episode closes with a broader look at fraud, program integrity, and why durable reform requires Congress to act. In This Conversation Why does 340B incentivize higher costs and hospital consolidation Contract pharmacies, diversion risk, and fraud exposure Who really benefits from 340B and why rural hospitals can lose out Medicare Part D premium pressure and the IRA tradeoffs Copays vs coinsurance and what seniors experience at the pharmacy counter Fraud, program integrity, and why limited resources should go to patients who need them Timestamps0:00 Why the 340B structure drives higher costs and consolidation0:37 Ryan Long joins Joe1:13 What has changed in 340B, and why it is getting attention6:57 Payer mix, spreads, and why wealthier systems benefit more11:06 How 340B expanded post-2010 and contract pharmacies16:56 Why contract pharmacy reform alone does not fix the incentives22:11 Medicare Part D and what the IRA changed24:23 Explaining the donut hole28:54 Premium increases, catastrophic coverage, and cost shifting32:26 Copays to coinsurance and unexpected out-of-pocket changes40:37 Fraud exposure and program integrity52:09 Where to find Ryan's work52:38 Outro 340B program, contract pharmacy, hospital consolidation, drug pricing, Medicare Part D, Medicaid rebate, Affordable Care Act, healthcare spending, healthcare costs, fraud exposure, policy impact, legislative reform, patient assistance About Our GuestRyan Long is a Fellow at the Paragon Health Institute and a Scholar at the USC Schaeffer Center. He previously served as health policy lead for Speaker Kevin McCarthy and is a longtime Energy and Commerce veteran focused on drug pricing, Medicare, Medicaid, and healthcare spending reform. Podcast: DC EKG with Joe GroganEpisode: 130Guest: Ryan LongSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios – https://www.stayoncourse.studio
In Episode 130 of DC EKG, Joe Grogan sits down with Ryan Long to unpack two policy stories that are driving real-world drug costs and healthcare spending: the 340B program and the fallout from Medicare Part D changes under the Inflation Reduction Act. Ryan explains why the current 340B structure can incentivize higher costs, hospital consolidation, and contract pharmacy expansion, while often directing the biggest windfalls toward larger, wealthier systems rather than truly resource-constrained hospitals. They cover contract pharmacies, exposure to diversion and fraud, Medicare Part B reimbursement dynamics, and why reforms need to address the incentives baked into the program. They then turn to Medicare Part D, the shift from copays to coinsurance, premium pressure, the accelerated move into “catastrophic” coverage, and what happens when Washington promises savings that do not materialize. The episode closes with a broader look at fraud, program integrity, and why durable reform requires Congress to act. In This Conversation Why does 340B incentivize higher costs and hospital consolidation Contract pharmacies, diversion risk, and fraud exposure Who really benefits from 340B and why rural hospitals can lose out Medicare Part D premium pressure and the IRA tradeoffs Copays vs coinsurance and what seniors experience at the pharmacy counter Fraud, program integrity, and why limited resources should go to patients who need them Timestamps0:00 Why the 340B structure drives higher costs and consolidation0:37 Ryan Long joins Joe1:13 What has changed in 340B, and why it is getting attention6:57 Payer mix, spreads, and why wealthier systems benefit more11:06 How 340B expanded post-2010 and contract pharmacies16:56 Why contract pharmacy reform alone does not fix the incentives22:11 Medicare Part D and what the IRA changed24:23 Explaining the donut hole28:54 Premium increases, catastrophic coverage, and cost shifting32:26 Copays to coinsurance and unexpected out-of-pocket changes40:37 Fraud exposure and program integrity52:09 Where to find Ryan's work52:38 Outro 340B program, contract pharmacy, hospital consolidation, drug pricing, Medicare Part D, Medicaid rebate, Affordable Care Act, healthcare spending, healthcare costs, fraud exposure, policy impact, legislative reform, patient assistance About Our GuestRyan Long is a Fellow at the Paragon Health Institute and a Scholar at the USC Schaeffer Center. He previously served as health policy lead for Speaker Kevin McCarthy and is a longtime Energy and Commerce veteran focused on drug pricing, Medicare, Medicaid, and healthcare spending reform. Podcast: DC EKG with Joe GroganEpisode: 130Guest: Ryan LongSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios – https://www.stayoncourse.studio
In Episode 130 of DC EKG, Joe Grogan sits down with Ryan Long to unpack two policy stories that are driving real-world drug costs and healthcare spending: the 340B program and the fallout from Medicare Part D changes under the Inflation Reduction Act. Ryan explains why the current 340B structure can incentivize higher costs, hospital consolidation, and contract pharmacy expansion, while often directing the biggest windfalls toward larger, wealthier systems rather than truly resource-constrained hospitals. They cover contract pharmacies, exposure to diversion and fraud, Medicare Part B reimbursement dynamics, and why reforms need to address the incentives baked into the program. They then turn to Medicare Part D, the shift from copays to coinsurance, premium pressure, the accelerated move into “catastrophic” coverage, and what happens when Washington promises savings that do not materialize. The episode closes with a broader look at fraud, program integrity, and why durable reform requires Congress to act. In This Conversation Why does 340B incentivize higher costs and hospital consolidation Contract pharmacies, diversion risk, and fraud exposure Who really benefits from 340B and why rural hospitals can lose out Medicare Part D premium pressure and the IRA tradeoffs Copays vs coinsurance and what seniors experience at the pharmacy counter Fraud, program integrity, and why limited resources should go to patients who need them Timestamps0:00 Why the 340B structure drives higher costs and consolidation0:37 Ryan Long joins Joe1:13 What has changed in 340B, and why it is getting attention6:57 Payer mix, spreads, and why wealthier systems benefit more11:06 How 340B expanded post-2010 and contract pharmacies16:56 Why contract pharmacy reform alone does not fix the incentives22:11 Medicare Part D and what the IRA changed24:23 Explaining the donut hole28:54 Premium increases, catastrophic coverage, and cost shifting32:26 Copays to coinsurance and unexpected out-of-pocket changes40:37 Fraud exposure and program integrity52:09 Where to find Ryan's work52:38 Outro 340B program, contract pharmacy, hospital consolidation, drug pricing, Medicare Part D, Medicaid rebate, Affordable Care Act, healthcare spending, healthcare costs, fraud exposure, policy impact, legislative reform, patient assistance About Our GuestRyan Long is a Fellow at the Paragon Health Institute and a Scholar at the USC Schaeffer Center. He previously served as health policy lead for Speaker Kevin McCarthy and is a longtime Energy and Commerce veteran focused on drug pricing, Medicare, Medicaid, and healthcare spending reform. Podcast: DC EKG with Joe GroganEpisode: 130Guest: Ryan LongSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios – https://www.stayoncourse.studio
“I'm Not Paying for Oil—I'm Protecting the Engine” There's a moment in our house where Lucas will look at me—calm as can be—and say, “Rachel… I'm not paying for oil. I'm protecting the engine.” And every time he says it, it reminds me of how people think about taxes. https://www.youtube.com/live/1bgZWYxu3jo Because an oil change feels annoying. It's inconvenient. It's not “fun money.” It's something you can easily delay—especially when life is full. But what Lucas understands is what most families don't realize until it's painful: small, responsible decisions today protect what you've built tomorrow. That's exactly what a Roth conversion strategy is. Not a trendy tactic. Not clickbait. Not “always do this” or “never do this.” It's stewardship. And it's one of the most misunderstood decisions families make—because it's not just about your tax bracket this year. It's about your lifetime taxes… and in many cases, your kids' taxes too. “I'm Not Paying for Oil—I'm Protecting the Engine”A Long-Range Roth Conversion StrategyRoth Conversion Strategy: Start With the Right Lens (Not a Hot Take)What Is a Roth Conversion?Why Roth Conversions Are Everywhere Right NowRoth Conversion and Future Tax Rates: The Real Issue Is ControlShould I Do a Roth Conversion? When It Makes Sense1) You're trying to reduce lifetime taxes (not just this year's taxes)2) You have high tax-deferred balances and don't expect to spend them down3) You have a window of lower-income years4) Your goal is tax diversification and retirement flexibilityRoth Conversion Mistakes to AvoidMistake #1: Ignoring IRMAA (Medicare Premium Surcharges)Mistake #2: Treating Roth conversions as staticMistake #3: Trying to time the market perfectlyHow Does a Roth Conversion Affect Your Heirs?Roth Conversion Estate Planning Strategy: When Roth Isn't the End GameReframe the Goal: Not “Highest Return,” but “Best Outcome After Taxes”What This Roth Conversion Strategy Changes for Your FamilyListen to the Full Roth Conversion Strategy EpisodeBook A Strategy CallFAQWhat is a Roth conversion strategy?When does a Roth conversion make sense?What are the downsides of a Roth conversion?Is it better to do Roth conversions when the market is down?How do I avoid Roth conversion mistakes? A Long-Range Roth Conversion Strategy In this blog (and podcast), Bruce Wehner and I unpack Roth conversions the way we believe every financial decision should be unpacked: with a long-range view, a clear understanding of tradeoffs, and a focus on control. If you're asking questions like: Should I do a Roth conversion? When does a Roth conversion make sense? What are the downsides of a Roth conversion? How does a Roth conversion affect my Medicare premiums (IRMAA)? How does the SECURE Act change inherited IRA taxes for my heirs? …this article is for you. You'll learn what a Roth conversion is, why people are talking about it more right now, and the biggest blind spots that can cost families real money—especially under the SECURE Act's inheritance rules. We'll also show you why this isn't a one-variable decision. The best Roth conversion planning is dynamic and integrated—because taxes, Medicare premiums, market timing, and estate planning all collide here. Roth Conversion Strategy: Start With the Right Lens (Not a Hot Take) Bruce opened our conversation with something that matters: There is no such thing as universal Roth conversion advice. If someone on social media tells you, “Always do a Roth conversion,” they're selling certainty—not stewardship. And if someone tells you, “Never do a Roth conversion,” they're doing the same thing in reverse. A real Roth conversion strategy requires your full financial picture. And not just your picture. It often requires understanding your heirs' tax picture, too. Because what happens after you're gone is part of the strategy—not an afterthought. If your goal is to pay the least amount of taxes over your lifetime and your family's lifetime, then this is a conversation worth slowing down for. What Is a Roth Conversion? A Roth conversion is when you move money from a tax-deferred account (like a Traditional IRA) into a Roth IRA. Here's the simple trade: With a Traditional IRA, you get a tax break today, but you pay taxes later when you withdraw. With a Roth IRA, you pay taxes now, and then your money can grow tax-free, and you can access qualified withdrawals tax-free. So the core question isn't “Do I like Roths?” The core question is: Do I want to pay the tax now or later—and what does that choice do to my lifetime tax bill and my heirs' tax burden? This is why we call it Roth conversion planning—because the conversion itself is just a move. The strategy is the plan around it. Why Roth Conversions Are Everywhere Right Now If you've noticed the sudden spike in Roth conversion content, you're not imagining it. Yes, people are thinking about inflation and national debt. But the bigger driver is a policy change that quietly shifted the math for families: The SECURE Act and the 10-Year Rule The SECURE Act changed how inherited IRAs work for most non-spouse beneficiaries. Before the SECURE Act, many beneficiaries could “stretch” distributions over their lifetime. That often meant smaller annual distributions and a more manageable tax impact. Now, in many cases, heirs must empty an inherited IRA within 10 years. That means more money forced out over a shorter time window, often during your child's peak earning years—when they're already in higher tax brackets. This is why the question “How does a Roth conversion affect your heirs?” is not a niche question. It's central. Roth Conversion and Future Tax Rates: The Real Issue Is Control One of Bruce's strongest points was this: You can try to predict future tax rates… but the bigger issue is control. Tax policy changes. Brackets change. Deductions change. Rules change. And governments are always solving for revenue. So instead of pretending we can forecast everything perfectly, we ask: How do we increase your control over when and how taxes are paid? That's what a tax diversification retirement strategy is about: having money in different “tax buckets” so you can choose how you pull income in retirement. Because a family with options has leverage. A family with only tax-deferred money has constraints. Should I Do a Roth Conversion? When It Makes Sense Let's bring it down to practical guidance. A Roth conversion can make sense when: 1) You're trying to reduce lifetime taxes (not just this year's taxes) If you're doing a Roth conversion to reduce lifetime taxes, you're looking at: your expected retirement income your required minimum distributions (RMDs) your spouse's situation your heirs' likely income levels future tax law uncertainty This is not a “this year only” decision. It's long-range strategy. 2) You have high tax-deferred balances and don't expect to spend them down Bruce sees this often with high net worth families. They have significant IRA/401(k) balances, but they live on cash flow from businesses, real estate, or other income sources. So the tax-deferred accounts are likely to be inherited—not consumed. That's when the SECURE Act 10-year rule becomes a real problem for adult children. 3) You have a window of lower income years Many families have lower income years: early retirement before Social Security a gap between selling a business and reinvesting proceeds years with unusually high deductions These windows can be ideal for Roth conversion planning, because you can “fill up” lower tax brackets strategically. 4) Your goal is tax diversification and retirement flexibility A Roth IRA can be a powerful tool for controlling adjusted gross income in retirement—especially when it comes to Medicare premiums and other phaseouts. But that leads to a major pitfall… Roth Conversion Mistakes to Avoid Mistake #1: Ignoring IRMAA (Medicare Premium Surcharges) If you're near Medicare age, this is huge. A Roth conversion increases your adjusted gross income (AGI). Higher AGI can trigger IRMAA—Income Related Monthly Adjustment Amount. In plain language:the more income you show, the more you can pay for Medicare Part B and Part D premiums. Bruce shared how common it is for people (and even many advisors) to miss this entirely. And here's the kicker: IRMAA is based on a two-year lookback so a conversion today can impact Medicare premiums two years from now This doesn't mean “don't convert.”It means: run the math. Because sometimes the tax savings over your lifetime is still worth it. But you should know what you're trading. Mistake #2: Treating Roth conversions as static Bruce said it well: this can't be a static strategy. It must be dynamic. He gave an example of a client who retired, started a multi-year Roth conversion plan, and then unexpectedly received a consulting contract paying several hundred thousand dollars. That income changed everything. Their conversion strategy had to be adjusted immediately—because the tax brackets, Medicare implications, and intended “conversion window” shifted. The point is simple: A Roth conversion strategy needs ongoing review. Mistake #3: Trying to time the market perfectly Yes, it can be advantageous to convert when markets are down. But most families wait for the perfect moment… and miss years of opportunity. Bruce's guidance is the steady kind of wisdom we live by: Control what you can control. Don't pretend you have a crystal ball. A good strategy often beats “perfect timing.” And in some cases, converting a depressed holding into a Roth can be a smart move—because future growth happens inside the Roth structure.
If you're a federal employee or retiree approaching age 65, you've likely asked: "Do I really need Medicare Part B if I already have FEHB?" In this Federal Fact Check episode, Micah Shilanski, Managing Partner and Wealth Advisor, explains how Medicare Parts A, B, and D work with your Federal Employees Health Benefits (FEHB) coverage, and what federal retirees should consider before deciding. In this episode, we discuss: • The 7-month Medicare enrollment window • When Part A is typically required • Why Part B is often considered "quasi-optional." • The 10% per year late enrollment penalty • How IRMAA can increase Medicare premiums • How FEHB prescription coverage impacts Part D decisions • Key financial planning considerations at age 65 Medicare decisions are highly personal and depend on your income, health outlook, and retirement plan. This episode is designed to help you understand the structure of the rules so you can make a more informed decision. If you're nearing 65 or helping someone who is, this conversation is worth your time. Check out the full episode here:https://zurl.co/Jake1 https://zurl.co/7P2P3
If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: https://www.eseniorinsurance.com✅ Call us: (801) 255-5340
If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: https://www.eseniorinsurance.com✅ Call us: (801) 255-5340
If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: https://www.eseniorinsurance.com✅ Call us: (801) 255-5340
If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: https://www.eseniorinsurance.com✅ Call us: (801) 255-5340
If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: https://www.eseniorinsurance.com✅ Call us: (801) 255-5340
Jim and Chris discuss listener emails on Medicare Part B decisions for retirees abroad, Social Security survivor benefit surprises, inherited Roth IRA distribution rules, and balancing Treasuries versus annuities when “safety” is more emotional than mathematical. (6:45) A listener asks about situations where it might make sense to skip Medicare Part B, including retirees living abroad with strong foreign coverage and people who move to the U.S. later in life and must pay for Parts A and B. (33:30) George asks why some widows and widowers don't end up receiving the full benefit their spouse was receiving, even when the surviving spouse's payment increases after the death. (52:30) The guys respond to a question about whether an inherited Roth IRA requires annual distributions when the original owner was old enough to have RMDs, or whether the beneficiary can wait until year 10. (1:11:00) Jim and Chris revisit the annuities versus Treasuries discussion through the lens of fear and peace of mind, including why someone might emotionally trust Treasuries more than insurer guarantees even if the math favors SPIAs. The post Medicare, Social Security, Inherited Roth, Annuities: Q&A #2607 appeared first on The Retirement and IRA Show.
The landscape of Social Security is changing yet again. As we enter 2026, six big changes will impact both current and future retirees. I break down everything from the new cost of living adjustment (COLA), increases in the earnings test limit, and updated eligibility requirements, all the way to shifts in the full retirement age and the solvency projections for the Social Security Trust Fund. You'll also hear practical tips on maximizing your Social Security benefits, how to prepare for what's ahead, and why it's more important than ever to have a solid retirement plan in place. You will want to hear this episode if you are interested in... [00:00] Social Security updates in 2026. [04:23] Social Security Cost of Living Adjustment (COLA). [09:00] Social Security earnings and credits. [13:41] Social Security benefits timing. [15:31] Social Security cuts looming in 2033. Key Social Security Changes in 2026 On the show, you'll hear an overview of these changes, helping you to prepare and adjust your financial plans accordingly. From increased earning limits to the solvency of the trust fund, here's what you need to know. 1. Cost-of-Living Adjustment (COLA): A Modest Boost One of the most anticipated changes each year, the Social Security cost-of-living adjustment (COLA), has been set at 2.8% for 2026—slightly higher than last year's 2.5%. This increase is designed to help benefits keep pace with inflation and is calculated automatically based on the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W) (as explained by Ryan Morrissey ). For retirees, this means an average monthly benefit increase of around $56 for singles and $88 for married couples. However, COLA's impact can be offset by hikes in Medicare Part B premiums, which have risen to $201.96 for 2026. This nearly $18 increase represents a 9.6% jump—higher than the COLA percentage—reminding retirees to monitor both Social Security and Medicare in tandem for accurate budgeting. 2. Earnings Test Limits: Collecting While Working If you want to claim Social Security before reaching your full retirement age and continue working, new earnings test limits apply. For those aged 62 until they reach full retirement age, the annual earnings limit is now $24,480, with benefits reduced by $1 for every $2 earned above this threshold. If you're in the year you hit full retirement age, the limit jumps to $65,160. Exceeding this means your benefit will be reduced by $1 for every $3 extra earned. Importantly, once you reach the month of your full retirement age, these limits disappear, and you can collect benefits without reductions regardless of income. 3. Earning Credits for Eligibility To qualify for Social Security, you must earn at least 40 credits over your working lifetime. For 2026, you'll receive one credit for each $1,890 earned per quarter—a slight increase over last year's $1,810. Most individuals accumulate the required credits after about 10 years of work. Earning more than 40 credits doesn't increase your benefit, but working longer and earning more can boost your payout through the average indexed monthly earnings calculation. 4. Social Security Wage Base Increase Social Security taxes apply to income up to a set wage base, which in 2026 rises to $184,500. Both employees and employers pay 6.2% up to this limit, which has increased by $7,500 over the last year. If you're self-employed, you cover both portions (12.4%). There's no cap on what you pay into Medicare, with a rate of 1.45%, and an additional 0.9% for higher earners. These thresholds have not been adjusted for inflation, making planning essential for those with larger salaries. 5. Full Retirement Age: Incremental Shift The gradual increase in full retirement age culminates in 2026. Those born in 1959 can claim full benefits at age 66 and 10 months, while anyone born in 1960 or later sees their full retirement age rise to 67. This change marks the final step in modifications enacted by the 1983 Social Security Act. After age 67, there are no planned increases—unless Congress takes further action. 6. Social Security Trust Fund: Solvency Concerns The long-term outlook for the Social Security Trust Fund remains a concern. Per the latest trustee report, benefits could be cut by 23% in 2033 if Congress does not act. Recent laws have expanded eligibility but also reduced system inflows, raising questions about solvency. For now, we don't need to panic; proactive planning and staying informed are key. Regularly review your Social Security status and plan contributions, and consider how these changes affect your overall financial strategy. Resources Mentioned Retirement Readiness Review Subscribe to the Retire with Ryan YouTube Channel Download my entire book for FREE Connect With Morrissey Wealth Management www.MorrisseyWealthManagement.com/contact Subscribe to Retire With Ryan
If you'd like to work with us on your Medicare health plan, we're licensed in 45 states and actively helping clients across the country. Christian and the team at Everything Senior Insurance represent many of the top insurance companies in the Medicare space. We're happy to help—just reach out! ➡️ Visit our site: https://www.eseniorinsurance.com✅ Call us: (801) 255-5340
In this Episode of the Secure Your Retirement Podcast, Radon and Murs discuss why Medicare 2026 is shaping up to be one of the most impactful years for retirees and those approaching retirement. With major Medicare updates, rising Medicare costs 2026, and several Medicare new rules taking effect, understanding how these changes affect your overall Retirement Planning is more important than ever. From prescription drug reforms to premium increases and income-based adjustments, Medicare is not something you can afford to “set and forget” when you're planning retirement and working to secure your retirement.Listen in to learn about how Medicare Part B premium 2026 increases, IRMAA surcharges, and Medicare income limits 2026 can directly impact your cash flow in retirement. Radon and Murs also explore how Medicare planning fits into a comprehensive strategy to help you retire comfortably, avoid costly surprises, and align your healthcare decisions with your long-term retirement checklist and broader financial plan.In this episode, find out:How Medicare drug price negotiations and Medicare Part D changes 2026 are lowering costs for certain prescriptionsWhat the new Medicare out of pocket cap means for retirees with high prescription drug expensesWhy the increase in Medicare Part B premium 2026 matters for your monthly retirement incomeHow IRMAA surcharges and income from strategies like Roth conversions can affect your Medicare premiumsWhat Medicare does not cover, including the difference between a Medicare wellness visit and a traditional physical, plus updates on Telehealth MedicareTweetable Quotes:“Medicare isn't separate from your financial plan—it's interconnected with your taxes, income, and investment strategy.” — Radon Stancil“One decision, like a Roth conversion, can trigger higher Medicare premiums if you don't account for IRMAA.” — Murs TariqUnderstanding Medicare 2026 is a critical part of Retirement Planning, whether you're already enrolled or just beginning to plan for retirement. Staying informed about Medicare updates, knowing your coverage gaps, and proactively planning can make a meaningful difference in how confidently you approach Retirement.Resources:If you are in or nearing retirement and you want to gain clarity on what questions you should be asking, learn what the biggest retirement myths are, and identify what you can do to achieve peace of mind for your retirement, get started today by requesting our complimentary video course, Four Steps to Secure Your Retirement!To access the course, simply visit POMWealth.net/podcast.
Roth conversions can save thousands in taxes, but they can also trigger Medicare IRMAA surcharges that quietly add up to more than $5,000 a year. Most retirees never see it coming, because the rules for Medicare premiums don't line up with the tax brackets everyone focuses on.In this video, James breaks down how Roth conversions interact with Medicare Part B and Part D premiums, why modified adjusted gross income matters more than taxable income, and how crossing a threshold by even one dollar can change your costs for an entire year. The case study shows how a couple could save nearly a million dollars in lifetime taxes… but lose tens of thousands to unnecessary IRMAA charges if they convert without a plan. A small adjustment (converting up to the right tier instead of the wrong bracket) boosts their long-term wealth and avoids surprise premiums.If you're planning Roth conversions before RMDs begin, evaluating a 401(k)-to-Roth strategy, or trying to minimize taxes in early retirement, understanding Medicare thresholds is essential. A smart conversion plan balances tax savings with premium costs so you don't give back what you worked so hard to save.-Advisory services are offered through Root Financial Partners, LLC, an SEC-registered investment adviser. This content is intended for informational and educational purposes only and should not be considered personalized investment, tax, or legal advice. Viewing this content does not create an advisory relationship. We do not provide tax preparation or legal services. Always consult an investment, tax or legal professional regarding your specific situation.The strategies, case studies, and examples discussed may not be suitable for everyone. They are hypothetical and for illustrative and educational purposes only. They do not reflect actual client results and are not guarantees of future performance. All investments involve risk, including the potential loss of principal.Comments reflect the views of individual users and do not necessarily represent the views of Root Financial. They are not verified, may not be accurate, and should not be considered testimonials or endorsementsParticipation in the Retirement Planning Academy or Early Retirement Academy does not create an advisory relationship with Root Financial. These programs are educational in nature and are not a substitute for personalized financial advice. Advisory services are offered only under a written agreement with Root Financial.Create Your Custom Strategy ⬇️ Get Started Here.Join the new Root Collective HERE!
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