Other medical expenses, such as doctors’ fees are covered under Medicare Part B. And though optional, subscribing to Medicare Part B is universally recommended.

The small premium for this coverage is automatically deducted from your Social Security payment, or will be billed to you if you have opted to delay collecting benefits. In addition to Medicare Parts A and B, the Social Security system gives you the opportunity to subscribe to prescription drug coverage under Medicare Part D. The complicated nature of this coverage has by now been well documented, so you should be sure to budget adequate time to determine the policy that will serve you best.

At your retirement you also have the option of choosing among many Medigap supplemental insurance policies that are designed to cover co-payments, coinsurance, and deductibles at different levels. While Medigap plans are offered by private companies, they must meet specific federal and state requirements in terms of benefits.

They do, however, differ in price. Deciding which, if any, Medigap policy is appropriate for you, requires both research and thought. While examining your options, keep in mind that you can’t enroll in a Medigap policy if you don’t enroll in Part D, but you can enroll in Part D without having a Medigap plan.

Perhaps the biggest complication for those who are retiring at 65 arises when their spouse has been covered through their workplace group policy.

The extent of that problem, however, depends on the size of the company. When a solo practitioner retires, his or her spouse will have to find insurance in the private market. Or for those with health problems, there is the additional option of a HIPAA guaranteed-issue health policy with high deductibles.

The spouse of a CPA who worked in a firm of fewer than 20 employees qualifies for continued group health insurance coverage under CalCOBRA. The spouse of a CPA who worked in a firm with 20 or more employees can continue health coverage under COBRA. These continuation options must, of course, be paid fully out of pocket at a rate that is higher than the premium for an employee.

You need to know how various parts of Medicare work, how they relate to the supplemental insurance policies (Medigap) and how they interact with your workplace group insurance plan.

In addition, understanding the relationship between Medicare and your group health policy becomes more important and more complicated if your spouse is covered under your plan at work. HIPAA, COBRA and CalCOBRA provisions may determine the availability of his or her coverage.Making a mistake in your coverage can be costly.  Frequently individuals neglect to enroll in the coverage they need only to discover this fact when confronted with large unpaid medical bills. It’s equally common to see people maintaining expensive policies that provide few benefits because they duplicate Medicare coverage.

Unfortunately the rules that govern Medicare can not be reduced to a few memorable rules of thumb. Since a large number of personal variables produce an even larger number of potential scenarios, it’s up to you to work out your options.

Variables to consider include the size of the firm in which you work, whether you will continue to work or not, whether your spouse is covered under your employer’s health plan, and whether you have experienced a disability before the age of 65. The table below summarizes these relationships, but further explanation is necessary.