Ready or Not, Here They Come: Medicare Enrollment Periods
Medicare Open Enrollment starts October 15, and people turning 65 in the next year have their own Initial Enrollment Period. Get ready by reviewing your options.
Fall is finally here, and with it, the time of year when we need to think about Medicare options. Medicare Open, or Annual, Enrollment runs every year from October 15 to December 7, and changes made during enrollment take effect January 1 of the following year.
What Should You Do Now?
· Don't wait until October to begin reviewing your options. Take time now to:
· Review your current Medicare plan and prescription drug coverage.
· Make a list of medications and confirm they will continue to be covered.
· Check whether your doctors and preferred healthcare providers remain in-network.
· Review your annual healthcare expenses and determine whether another plan may better meet your needs.
· Watch for the Annual Notice of Change (ANOC) from your current plan, which outlines changes in premiums, deductibles, copayments, and benefits for the upcoming year.
· Gather questions and schedule time with a trusted Medicare professional if you need assistance comparing options.
Medicare Decision-Making Resources
Official Medicare Website. Medicare.gov provides information on enrollment periods, coverage options, premiums, and plan comparisons.
Medicare Helpline. Available 24 hours a day, 7 days a week.
1-800-MEDICARE (1-800-633-4227)
TTY: 1-877-486-2048
State Health Insurance Assistance Program (SHIP). SHIP offers free, unbiased Medicare counseling to help beneficiaries understand their options. Each state’s SHIP may go by a different name. For example, in Michigan, this program is called the Michigan Medicare Assistance Program (MMAP). Find your local SHIP with this online finder.
Even small changes in coverage can have a significant financial impact. For example, if you don’t review your Part D coverage, you may experience an unpleasant surprise come January if a medication that was cheap or free this year was moved to a higher cost tier, or dropped from the formulary entirely, for the next plan year.
Turning 65? Don't Delay Enrollment.
Many individuals approaching age 65 believe they can postpone Medicare enrollment because they are healthy and do not currently need medical services. However, enrolling on time is important.
Benefits of enrolling when first eligible include:
· Avoiding potential late enrollment penalties that may increase costs for life. The penalties increase the longer you wait to enroll, and they stick around forever.
· Ensuring access to healthcare coverage before unexpected medical needs arise.
· Taking advantage of preventive services, wellness visits, screenings, and other Medicare benefits.
· Avoiding gaps in coverage during transitions such as retirement or changes in employer-sponsored insurance.
· Gaining peace of mind knowing healthcare protection is in place.
In terms of the penalties, there’s one big exception: if someone is still working past 65 and covered by a current employer's group health plan (theirs or a spouse's), they may be able to delay Part A and Part B without a penalty.
Your Initial Enrollment Period (IEP) is a one-time, personal window tied to your birthday, and it’s separate from Open or Annual Enrollment. Your IEP generally begins three months before your 65th birthday month, includes your birthday month, and continues for three months afterward. So if you turn 65 in June, your window runs March through September. (One quirk: if your birthday falls on the 1st of the month, Medicare treats you as if you were born the month before. So someone turning 65 on June 1 would have an IEP running February through August, not March through September.)
Even if you feel healthy today, Medicare planning is about preparing for tomorrow. Healthcare needs can change unexpectedly, and timely enrollment helps protect both your health and financial well-being.
As with all aspects of retirement planning, being proactive can help you make informed decisions and avoid costly surprises. Be sure to talk with a fiduciary financial advisor and use the resources in the sidebar to get all your questions answered.
Is Medicare Even Going to Be Around After 2030?
Rumors and anxieties are currently flourishing about the long-term health of Medicare itself. Let’s dig into it.
Medicare Parts B and D are funded through beneficiary premiums and U.S. Treasury funds, and these inputs are more or less consistent with spending over time. Concerns stem from the 2026 Medicare Trustees Report, which found that by 2032, the trust fund income upon which Medicare Part A relies will run dry. At that point, Part A would only be able to pay out what it brings in from payroll taxes, and that won’t be enough to cover healthcare costs that are rising faster than inflation and wages.
All this doesn’t mean that Medicare disappears or stops functioning in 2033. It means the Part A trust fund's reserve cushion will be gone, and what it collects in taxes will only cover roughly 89% of scheduled Part A costs. Legally, Medicare won’t be able to spend any more than that, absent Congressional action.
Congress has taken action before to boost Medicare, an extremely popular program on both sides of the political aisle. So it’s likely enough that they’ll take action again to make sure that Medicare can cover that projected 11% gap that the trust fund now covers.
But advocacy will be important. AARP, among other organizations, is starting now to ensure that this issue is top of mind for lawmakers. “Medicare financing should be broad-based, stable and progressive,” AARP says. “Policymakers should ensure state laws and regulations do not reduce or undermine consumer access, affordability and quality in the Medicare program.” As we get closer to 2033, get ready to sign some petitions and call your legislator if you want to see Medicare funded at its current levels.
This article is not intended to be a substitute for professional financial advice from a qualified financial advisor.
Additional Sources:
https://www.congress.gov/crs-product/R43122
https://www.uhc.com/medicare/medicare-education/medicare-initial-enrollment-period.html
https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-d/medicare-part-d-formulary/
Blog posting provided by Society of Certified Senior Advisors
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