Medicare Open Enrollment 2025: Eligibility, IRMAA, and How to Choose Between Select and Advantage
Medicare can feel overwhelming when you first approach it. Between the alphabet soup of Parts A, B, C, and D—and the timing rules that carry lifelong consequences—it’s easy to get lost. With open enrollment right around the corner, let’s simplify the key decisions you’ll face if you’re enrolling for the first time.
Who’s Eligible for Medicare?
Most Americans become eligible for Medicare at age 65. If you or your spouse worked at least 10 years and paid Medicare taxes, you generally qualify for premium-free Part A (hospital coverage).
If you’re under 65, you may still qualify if you’ve been receiving Social Security Disability Insurance (SSDI) for 24 months, or if you have certain medical conditions such as ALS or End-Stage Renal Disease.
Understanding Enrollment Periods
Your Initial Enrollment Period (IEP) begins 3 months before the month you turn 65 and lasts until 3 months after. Enrolling on time is critical—waiting too long can lead to permanent late enrollment penalties.
The Open Enrollment Period, which runs October 15 – December 7 each year, allows you to:
Switch between Original Medicare and Medicare Advantage (Part C)
Change Part D prescription drug plans
Review your coverage to make sure it still fits your needs
The Role of IRMAA
For higher-income retirees, Medicare comes with an extra layer: the Income-Related Monthly Adjustment Amount (IRMAA). This is an additional premium added to Part B and Part D if your income from two years prior exceeds certain thresholds.
For example, a single filer with income above $103,000 (2024 thresholds) will pay more for coverage. This means your tax planning in retirement directly impacts your healthcare costs.
We believe this is where financial and tax planning intersect in a very real way—because sometimes, a well-timed Roth conversion can save you thousands in future IRMAA surcharges.
Source: Holistiplan. Assumes Married Couple
Medicare Select vs. Medicare Advantage
This is a point of confusion for many new enrollees.
Medicare Select is a type of Medigap (supplemental insurance) plan. It usually has lower premiums, but you must use a specific hospital network for non-emergency services. It supplements Original Medicare (Parts A & B) but with restrictions on providers.
Medicare Advantage (Part C) is an alternative to Original Medicare. These are private plans that bundle hospital, medical, and often prescription drug coverage. They may include extras like dental or vision, but you typically give up some flexibility in choosing providers.
The choice between the two often comes down to whether you value lower costs and simplicity (Advantage) or flexibility and broader provider choice (Original Medicare + Medigap or Select).
For Dual-Home Retirees
If you split your time between two homes—say, six months in Texas and six months in Colorado—your Medicare choice deserves extra attention.
Medicare Select: These plans require you to use specific hospitals for non-emergency care, usually within one local network. That can be a problem if you spend months away from your “home” area. Emergency care is covered anywhere, but routine visits could be out-of-network.
Medicare Advantage: Advantage plans are county-based, meaning your available plans are tied to your official residence ZIP code. Some PPO-style Advantage plans offer partial national networks, but many HMOs do not. If you seek care in your second state, you may have to pay more or travel back for in-network providers.
Original Medicare + Standard Medigap: For those with two homes, this combination usually offers the greatest flexibility. You can see any provider nationwide who accepts Medicare—no networks, no location limits.
👉 Rule of thumb:
Select = stay local
Advantage = works for some snowbirds, but check networks carefully
Original Medicare + Medigap = best for full flexibility across states
Putting It Together
For many retirees, Medicare is the first major financial decision after leaving the workforce. Choosing the right coverage isn’t just about health—it directly affects your long-term financial security.
At Sevey Wealth, we believe confidence comes from clarity. The Medicare system is full of moving parts, but when you understand the basics—eligibility, timing, IRMAA, and how plan types fit your lifestyle—you’re better positioned to make choices that support both your health and your wealth.
✅ Action Step: If you’re approaching 65 or reviewing coverage during open enrollment, take time to compare your options carefully. What fits your neighbor may not fit you.
👉 Want help understanding how Medicare fits into your retirement plan? Schedule a consultation
