Medicare Open Enrollment begins October 15, and if you’re waiting until then to start thinking about it, you might already be a step behind. The most impactful work happens well before the first plan comparison ever gets made and September is the month to do it.
At a Glance
- Medicare Open Enrollment runs October 15 through December 7. Changes take effect January 1.
- Your Medicare premiums are determined by your income from two years ago, meaning the financial decisions you make today directly impact what you’ll pay in the future.
- Strategic income planning before and during retirement is one of the most powerful tools for managing Medicare cost, and it’s where working with a financial advisor makes a real difference.
What Is Medicare Open Enrollment?
Each year between October 15 and December 7, Medicare beneficiaries can make changes to their coverage. This includes switching between Original Medicare and Medicare Advantage, adjusting a Part D drug plan, or modifying existing coverage. Whatever you choose takes effect January 1. For retirees managing significant assets, the decisions that most affect what you actually pay happen long before the first enrollment screen loads.
How Does My Income Determine My Premiums?
Medicare premiums aren’t the same for everyone. Higher-income beneficiaries pay IRMAA surcharges (Income-Related Monthly Adjustment Amounts) on top of standard Part B and Part D premiums, and those surcharges are calculated based on your modified adjusted gross income (MAGI) from two years prior. That two-year lag is what makes early planning so critical, and so easy to overlook.
A Roth conversion, a large RMD, a home sale, or even interest from municipal bonds can quietly push your MAGI over an IRMAA threshold. For retirees with multiple income sources, the math can get complicated fast.
Why Is September the Time to Act?
By the time open enrollment opens in October, your 2025 income is already locked in, but your 2026 income is still within reach. September gives you a meaningful window to review your year-to-date income picture and make smart adjustments before December 31.
Depending on your situation, that might mean timing a Roth conversion carefully to stay below an IRMAA threshold, using tax-loss harvesting to offset gains, or making a qualified charitable distribution (QCD) instead of a traditional RMD withdrawal. For those over 70½, QCDs are particularly useful; they satisfy the RMD requirement without the distribution counting toward taxable income.
If you’ve had a major life change this year, such as retirement, divorce, or loss of a spouse, you may also be eligible to appeal your IRMAA determination directly with the Social Security Administration using Form SSA-44.
These are exactly the kinds of conversations we’re having with clients right now. Proactive income planning in the months before year-end can meaningfully reduce Medicare costs for years to come. It’s one of the many reasons working with a financial advisor pays off well beyond investment management.
What Should I Review When Open Enrollment Arrives?
Once Medicare open enrollment opens, the focus shifts to your plan itself. Your insurer is required to send an Annual Notice of Change each fall outlining what’s different about your coverage for the coming year. Make sure you read it to understand what’s changed.
If you’re on a Medicare Advantage plan, you should confirm your preferred providers are still in-network and that your prescriptions remain covered at the same tier. Networks and formularies shift annually, and a plan that worked well last year can look very different on paper by January.
It might also be worth exploring if you and your spouse need to be on the same plan. If your medical needs or medications differ, evaluating coverage individually often leads to better outcomes for both of you.
Don’t forget: The enrollment window closes December 7, not December 31. It’s a common misconception that costs people time when they need it most.
Stay Ahead of Every Deadline
Medicare open enrollment is just one of the financial deadlines that can affect your retirement. Our monthly blog covers the topics that matter most to retirees and pre-retirees, so you’re never caught off guard. If you’re not already subscribed to our newsletter, now is a great time to sign up and get updates delivered directly to your inbox every month.
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