Medicare

Medicare Open Enrollment: Five Things You Need to Do

November 30, 2015 • By

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Last Updated: November 30, 2015

medicare 50th anniversary Routines help keep us focused, organized, and even healthy. However, if your health routine doesn’t include preparing for Medicare’s Open Enrollment, now’s the time to kick-start a new healthy habit.

If you have a Medicare health or prescription drug plan, you should review and compare coverage options. The Open Enrollment runs through December 7 and is the time you can make changes to your plan. Even if you’re happy with your current coverage, you might find a better fit for your budget or your health needs. If you miss an Open Enrollment deadline, you’ll most likely have to wait a full year before you can change your plan.

Here are five things every Medicare beneficiary can do to get in the Medicare Open Enrollment routine.

  1. Review your plan notice. Be sure to read any notices from your Medicare plan about changes for next year, especially your “Annual Notice of Change” letter. Look at your plan’s information to make sure your drugs are still covered and your doctors are still in network.
  1. Think about what matters most to you. Medicare health and drug plans change each year and so can your health needs. Do you need a new primary care doctor? Does your network include the specialist you want for an upcoming surgery? Does your current plan cover your new medications? Does another plan offer the same value at a lower cost? Take stock of your health status and determine if you need to make a change.
  1. Find out if you qualify for help paying for your Medicare. Learn about programs in your state to help with the costs of Medicare premiums, your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) deductibles, coinsurance and co-payments, and Medicare prescription drug coverage costs. Visit Medicare.gov or make an appointment with a local State Health Insurance Assistance Program (SHIP) counselor if you need help.
  1. Shop for plans that meet your needs and fit your budget. You can use the Medicare Plan Finder tool to see what other plans are offered in your area. A new plan may:
  • Cost less;
  • Cover your drugs costs; or
  • Let you use the providers you want, like your doctor or pharmacy.

If you find that your current coverage still meets your needs, then you don’t need to make any changes. Remember, during Medicare Open Enrollment, you can decide to stay in Original Medicare or join a Medicare Advantage Plan. If you’re already in a Medicare Advantage Plan, you can switch back to Original Medicare.

  1. Check your plan’s star rating before you enroll. The Medicare Plan Finder includes Star Ratings for the 2016 Medicare health and prescription drug plans. Plans are rated for quality on a one- to five-star scale: one star represents poor performance and five stars represent excellent performance. Be sure to use the ratings to compare the quality of any health and drug plans you are considering.

These are a few easy ways to get a jump-start on your Medicare Open Enrollment. For more information, call 1-800-MEDICARE (1-800-633-4227) and say “Agent.” TTY users should call 1-877-486-2048. Help is available 24 hours a day, including weekends. If you need help in a language other than English or Spanish, let the customer service representative know the language. You can also visit a local SHIP counselor. SHIP counselors provide free, one-on-one, non-biased Medicare assistance. Get free personalized health insurance counseling by calling your SHIP at the number listed on the Medicare contacts page or call 1-800-MEDICARE.

 

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About the Author

Dr. Patrick Conway, CMS Principal Deputy Administrator and Chief Medical Officer

Dr. Patrick Conway, CMS Principal Deputy Administrator and Chief Medical Officer

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Comments

  1. Kori

    I’m on SSD with government helping with my ins. payment for parts A & B. I also have part D for my medicines. I’m wondering if all this works for me, do I need to have a supplemental ins.? Does that just help for part C? Or does it help with the 20% that is not converted? I have Share of Cost with Medicaid but it’s $1,669.00 every month! My check wouldn’t even cover this! How can I be approved for SSD with all this other help but have a ridiculous amount with the State???? Pls. help me, do I just need a supplemental ins? Thanks

    • bettyg

      kori, are you ON MEDICARE?

      if yes, look into HUMANA PPO; current deductions are $47.00/month plus HUMANA gets what SS pays for medicare.

      they’ve done a good job in the 3-4 years we;ve had it.

      bcbs we were paying $1200/month then it went up another $500/month to $1700 !!
      highway robbery; glad we got RID OF BCBS.

      there are others out there that will pay.
      i end up in the DONUT hole due to all my meds especially the expensive bydureon injecton shots for my diabetis.

      good luck.

      bettyg, iowa
      went from ssdi to RETIRED when i turned 66

  2. winston f.

    My wife Lourdes Virginia Wallis and my self are presently covert by Medicare. We were just declared not eligible for SSI and got immediately a letter from AHCA indicating that our Medic Aid would stop unless justifying and declare eligible by DCF. It is urgent to define what our situation is.
    We are appealing to SSA formally . We did it personally and did not work.
    The date expiration is today. Can I get an extension?
    Winston and Lourdes Wallis (7902) (1719)

    • R.F.

      Unfortunately, your question is a bit more complex than we can handle in this forum. For your security, we do not have access to information about your account in this venue. Please call our toll-free number at 1-800-772-1213 for assistance. Representatives are available Monday through Friday, between 7 a.m. and 7 p.m.

  3. sham s.

    I was disabled senior citizen and i had heart attack/stroke in 20004.My company paid disabilities for two years and stopped afterwards. How can i get social securities indefinitely. Do i need a lawyer to process my disability with social security? I am permanently disabled on job and now retired by my company on disability.Will i get a social security as i am getting at present.

    • R.F.

      Unfortunately, your questions are a bit more complex than we can handle in this blog. Please call our toll free number at 1-800-772-1213 from 7 a.m. to 7 p.m. Monday through Friday or visit your local Social Security office.

      • Lorrie M.

        you say you are a senior citizen with disabilities. From social security you only receive one payment. you would not get your social security payments for being retired senior citizen and a social security disability payment too.

        People who receive social security disability payments have not yet reached retirement age. Once they do, the payments switch to regular social securtiy for senior citizens who are retired. Typically the amount of the monthly payment does not change though.

    • ELois P.

      It never hurt to contact a S.S. attorney. Try and watch for the commercials on tv and get their number OR have someone GOOGLE S.S. attornies numbers for you.

  4. Lic. P.

    Good morning.
    I am concerned with the Medicare Card Number, that its the number of our social security. It is necessary to change this identification cards for another more safe, and without this secret number. The card need more security, against the thief of identity.

    Thank you so much for your time.

    Pierre Millet
    Cuban lawyer
    U.S. citizen

  5. Lawrence f.

    I need a work history and jobs you have listed for me , i need it for my State pensión i belive they did not count My national guard time ,and other jobs.

    • R.F.

      To obtain a “Detailed Earnings Information” record, you must complete and mail a request (Form SSA-7050-F4) to the address provided in the form. You can also create a my Social security account to review your earnings record. For more information, you can call our toll free number at 1-800-772-1213. Representatives are available Monday through Friday between 7:00a.m. and 7:00p.m. We hope this information helps!

  6. Gary

    I would like the Social Security people and advertisers to distinguish between the government Medicare program and private Medicare Supplemental insurance policies. Apparently, there are multiple choices under multiple choices. One word, “supplemental”, would make it more clear to the aged population. “Medicare Advantage” means nothing to me. Thank you.

  7. Steve

    How can I change my address and get a new social security card if I can’t get to the local office. I’m100% disabled and have no one to take me there. Could you please let me know. Thank you.

    • Trisha

      sign in to the social security website and ask for a new card also to change your address. You need to have a web account on the site to do that.

    • R.F.

      Hello Steve, if you are receiving Social Security benefits, you can create a my Social Security account to change your address online first. If you are receiving SSI, you must report the new address to your local Social Security office. If you are not yet receiving benefits, you don’t need to change your address with us at this time.
      If you need a replacement Social Security card, you can mail the application and required documents to your local office. Please visit our “New or Replacement Social Security Number and Card” web page, to learn more on the process and what documents you will need to get a card. Please make sure that you use your new address in your application for a replacement Social Security card.
      You can also call our toll free number at 1-800-772-1213 (TTY 1-800-325-0778) for further assistance. Representatives are available Monday through Friday between 7:00a.m. and 7:00p.m. Generally, you’ll have a shorter wait time if you call later in the week. Hope this information helps!

      • Ice

        Yeah that’s what I’m talking about ba-icbny-e work!

      • Bella

        I really think you need to never ever ever never not going to happen let Patti fix you up with anymore blind dates.. obviously, he’s to sh03&t#82ro;

    • ELois P.

      Do you have a homecare person? If so, ask them to assist you at getting transportation to get to the S.S. office. We ALL, have a right to transportation and you should have extra rights because you are totally disabled!

      • Alejandra

        As Medicare recipients gahter information for the November 15 enrollment date, I recommend PlanPrescriber.com for help with finding the Medicare health plan options in your zip code and doing a plan comparison of benefits. You will also be able to determine whether your current doctor accepts a plan you are considering.

  8. Wayne S.

    i am not sure that this pertains to me does anyone else have SSI by being Disabled before the age of 60?

    • noreen w.

      I do I want yo know if I qualify for other benefits, I was told by the sso I didn’t qualify for any more benefitd

    • R.F.

      Hi Wayne, the Supplemental Security Income or SSI program is a needs-based program that pays benefits to disabled adults and children who have limited income and resources. SSI benefits are also payable to aged people (65 and older) who have limited income and resources.

    • lizroden61@ymail

      Yes I do social security clerk told me that if I didn’t take now that if my illnesses become worse an needed more medications an I reapply like two or three years from now I was gona be penalized 10 percent each year for not taking it when it the first year it was offered to me ir I could wait til I was 65 do I took now so I dint get penalized but I think it depends on your health to buy the state will help with the social security premium that you pay each month that comes out of your benefits that what I’m working on now

      • Lorrie M.

        there is an exception to what you were told. If you are a veteran they cannot charge you those penalties.

        My dad was told he would have an outrageous penalty to pay, as he never signed up for part d as didn’t understand it.

        An independent insurance man told me about the veterans insurance exception at an informational meeting I happened to go to. It was correct.

  9. Rakesh g.

    I have Medicare part A only, and that’s all I want to have for next year also, because I have employer sponsored health insurance. Do I need to re-enroll or do anything? I think re-enrollment is for those who are making change. Am I right?

    • Dena

      If all you want is your Part A, you do not have to do anything. Open Enrollment is for people with Part D drug insurance and Part C Medicare Advantage health plans

      • Raffaele

        Most employers have poiicles that allow for you to add spouses and children to your plan but will most likley ask you to contribute to the premium.These poiicles are usually outlined in your employee handbook and if you don’t have one, the HR department or your boss should be able to easily answer your questions. It’s a home human resources issue that comes up frequently.References : personal experience.

    • R.F.

      This “open Enrollment” is for people who don’t have health coverage. Medicare isn’t part of the Health Insurance Marketplace, so if you have Medicare coverage combined with a job-based health insurance program and if you find that your current coverage still meets your needs, then you don’t need to make any changes. However, you should speak to your personnel office, health benefits advisor, or health plan to see what’s best for you. You can also visit http://www.Medicare.gov for more information. Generally, if you or your spouse are still working and you are covered under a group health plan based on that employment, you don’t need to file for Medicare part B until you or your spouse stops working or drops health care coverage. We hope this information helps!

      • Ernest

        I was told that if I am still working and have health insurance through my employer, then I don’t have to sign up for ANY Medicare, not Part A or any other even though I’m 65. Was that wrong?

        • Fay

          I was told to sign up for Medicare Part A. It doesn’t cost anything. Medicare told me I needed to do that by age 65. I’m still working so that is the only medicare card I have.

          • R.F.

            Hi Fay, if you are actively working and covered under your employer’s group health insurance program, you can delay enrollment into Medicare Part B until you stop working or the health coverage is dropped. However, we suggest that individuals speak to their personnel office, health benefits advisor, or health plan to see what’s best for them, and to prevent any penalties or delayed enrollment in the future. To learn more about the Medicare enrollment periods visit http://www.Medicare.gov.

        • MADELYN T.

          I am still working full time, and I don’t need Medicare part D.I have good coverage with my employer. I’ve been harassed by phone and by mail. For months I’ve told this to people calling me about purchasing Insurance that I don’t need or want. I plan on working until July 2021 and I don’t want to purchase Medicare part D I will pick my own insurance when I’m ready .I don’t want money taken out of my check for this insurance. I can use that $144.60 myself on groceries.

    • ELois P.

      I would suggest that you contact them first, to find out IF, you need to re-enroll, in order to clarify your situation.

  10. Phyllis

    Could someone tell me why we are not offered more dental than “upkeep?”

    • Penelope M.

      Because “Medicare’ is not well informed about the importance of dental care to wellness? Perhaps, the Medicare officials need to update themselves on more areas to keep us healthy rather than treating us after the Medicare system failed us.

      • Bunny L.

        Hi Phyllis, I have not followed through but I did read that we can apply for “real” Dental insurance to Delta Dental. This is the Dental plan I have had for years as an Employer provided plan and through Obamacare. It is not too expensive. I believe it was $49 a month under Obamacare. This is my first month on Medicare.

    • ELois P.

      I’m sorry thaty I have no reasonable answer for your question, but (if you will), can you put me in contact with people who can HELP my family get justice for my brother who has been raped over a 20 year span and abused in other ways at Chester MHC? I can be contacted at (773)826-2591. ATTN: We have SUBSTANTIATED COMPLAINTS(after years of CMHC COVERING UP these abuses) and it is STILL being covered up. PLEASE HELP!

Comments are closed.