24 Sep Medicare Open Enrollment: Review Before December 7

Medicare Open Enrollment: Review Before December 7

Coverage decisions made this fall take effect January 1. A few minutes of review now can prevent surprises later.

Every year, from October 15 through December 7, Medicare’s Open Enrollment Period gives current beneficiaries a window to review and adjust their coverage for the year ahead. Any changes made take effect January 1.

For many retirees, this period quietly comes and goes without much thought. But healthcare costs are one of the more significant, and less predictable, expenses in retirement, and a short annual review can meaningfully affect both your out-of-pocket costs and your overall retirement income plan.

What You Can Actually Change

Open Enrollment is specifically for people already enrolled in Medicare. During this window, you can:

• Switch from Original Medicare to a Medicare Advantage plan, or vice versa
• Switch from one Medicare Advantage plan to another
• Join, drop, or switch a Medicare Part D prescription drug plan
• Add or drop drug coverage within a Medicare Advantage plan

If you’re approaching 65 and not yet enrolled, your initial enrollment window works differently and is tied to your birthday month, not this fall period.

What’s Changing for 2027

A few developments are worth having on your radar as you compare options this year:

• The Part D out-of-pocket cap is rising. CMS has finalized rules that continue phasing in the Inflation Reduction Act’s redesign of the Part D benefit. The annual out-of-pocket threshold for prescription drug costs, which stood at $2,100 in 2026, is set to increase further for 2027.
• Part D deductibles are also increasing. Standard deductibles are trending higher year over year as these benefit changes are codified into permanent CMS regulation rather than temporary guidance.
• Plan and premium changes vary by market. Medicare Advantage plan availability, premiums, and supplemental benefits shift annually. The Annual Notice of Change (ANOC) mailed by your current plan each fall is the most reliable way to see exactly what’s different for you specifically.

None of these changes are dramatic on their own, but taken together, they’re a reminder that “auto-renewing” the same plan every year isn’t always the most cost-effective choice.

The Piece Retirees Often Miss: IRMAA

For higher-income retirees, one of the more overlooked aspects of Medicare is the Income-Related Monthly Adjustment Amount, or IRMAA, a surcharge added to Part B and Part D premiums for beneficiaries above certain income thresholds.

IRMAA is based on your modified adjusted gross income from two years prior. That two-year lookback matters: a large one-time income event, such as a Roth conversion, the sale of a business, or a large capital gain, can trigger higher Medicare premiums two years later, sometimes catching retirees off guard.

This is one of the clearer examples of why healthcare and income planning shouldn’t be treated as separate conversations. The timing of withdrawals, conversions, and asset sales can have a direct, delayed effect on what you pay for Medicare.

A Short Checklist for This Fall

1. Read your plan’s Annual Notice of Change. It arrives every September and outlines exactly what’s changing about your current coverage for next year.
2. Compare your total expected costs, not just premiums. Deductibles, copays, and your specific prescription list can matter more than the sticker price of a plan.
3. Check whether a recent or upcoming income event could affect your IRMAA bracket. If you’re planning a Roth conversion or anticipate a large gain, it’s worth modeling the Medicare premium impact alongside the tax impact.
4. Coordinate with your broader income plan. Healthcare costs should be built into your retirement income and withdrawal strategy, not treated as a separate line item reviewed once a year in isolation.

Final Thoughts

Medicare Open Enrollment is a narrow seven-week window, but the decisions made during it echo for a full year. For retirees and near-retirees, reviewing coverage alongside your income plan, rather than as a standalone task, is one of the more practical ways to protect both your health coverage and your financial plan.

As part of our Path to Prosperity process, we help clients look at healthcare costs as one piece of a coordinated retirement income strategy, alongside tax planning, withdrawal sequencing, and long-term care considerations. If Medicare decisions this fall feel more complicated than they should, we’re glad to help you work through them.

This article is for general informational and educational purposes only and does not constitute individualized tax, legal, or insurance advice. Medicare rules, costs, and enrollment periods are current as of publication and subject to change; confirm current-year details with Medicare.gov or a licensed insurance professional. Securities offered through Kestra Investment Services, LLC (Kestra IS), member FINRA/SIPC. Investment advisory services offered through Kestra Advisory Services, LLC (Kestra AS), an affiliate of Kestra IS. Coltiva Wealth Planning Partners is not affiliated with Kestra IS or Kestra AS. Neither Kestra IS nor Kestra AS provides tax or legal advice.

—

Sources:

• Medicare.gov, “Open Enrollment” and “Your Yearly Medicare Review”
• Centers for Medicare & Medicaid Services, “Medicare Open Enrollment” partner resources and “Contract Year 2027 Medicare Advantage and Part D Final Rule”
• KFF, “What to Know About the Medicare Open Enrollment Period and Medicare Coverage Options”
• Axene Health Partners, “2027 Medicare Advantage and Part D Advance Notice – Deep Dive”