Medicare Open Enrollment: Five Things You Need to Do
Reading Time: 3 MinutesLast Updated: November 30, 2015
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.
- 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.
- 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.
- 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.
- 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.
- 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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Tags: Medicare, social security, SSA
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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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Jorge
My Social Security net benefits had been protected until Benefit Year 2017 by the Hold Harmless Rule as it applies to Medicare premiums. I have been a member (enrolled in) a Medicare Advantage Plan (Humana) for 5 years. Late October 2017, during the Open Enrollment Period, I opted to change to a similar Medicare Plan within Humana for 2018. In January 2018, I received a letter from Social Security advising me that my net monthly pension benefits for 2018 were reduced by $70.00 from that of my 2017 Benefit amount. My Hold Harmless protection was no longer in effect and my Medicare premium was increased to the full premium of $134 per month.
Before I initiated my change of Medicare Advantage Plan (all handled directly with Humana), Social Security had confirmed to me in writing the amount of my Net Benefits for 2018, increase in my Medicare premium due to COLA, but no reduction in my Net Benefits.
I have been in contact with both Social Security and Humana and both refer me to the other.
In last communication from Social
Security, they made reference to
“HI 01001.255 Beneficiary Dropped from Group Payment Plan” as reason for the change in my Social Security benefit.
I am at a loss and would appreciate your insight as to what and how HI 01001.255 Beneficiary Dropped from Group Payment Plan has impacted my loss of the Hold Harmless Protection.
Thank you!
Ray F.
Unfortunately, but for security reasons, we do not have access to personal records in this blog. Please continue working with your local office. You can request to speak with the manager to see how we can clarify all issues and find a resolution to your situation. If you are unable to visit the local office, you can call our toll free number at 1-800-772-1213, representatives are available Monday through Friday, between 7 a.m. and 7 p.m. Generally, you will have a shorter wait time if you call later during the day or later in the week. Thanks.
Theodore L.
my prescription coverage changed effective April 1, 2018 following my spouses retirement. At that time I enrolled in an AARP drug coverage plan and thought I had also enrolled I Medicare Part D coverage.
Is there a way to determine if I did enroll in Part D coverage? If I have not done so already, where can I find the enrollment form? I realize this is outside the normal enrollment period, however, it is my understanding that due to changes to my coverage (employer provided through March 31, 2018) late enrollment penalties would not apply. Is this true?
Jerry S.
I never received my Medicare card and birthday is June 3! Please help!
Jerry S.
Please help
Guy
really not helpful information. You are telling people in our age group to shop for the best plan that fits our budget. This ain’t our first rodeo here. Check the rating? You think we won’t. Duh..”Hey guys we are really stupid ducks here. Just like sell us any ole plan you have laying around the office.”
Nancy S.
Is this information available in Japanese?
Is there a deadline to sign up for Medicare? My friend is working and may be 66.
Does signing up for Medicare somehow affect Social Security?
cat h.
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Erin C.
I need to know where I can apply for Medicare Part A & B online. I found the “Just Medicare” app. And the Medicare Part B app. But I could not find an app for both Medicare Part A AND B. Please send me the link.
Ray F.
When you apply for Medicare, you can sign up for Part A (Hospital Insurance) and Part B (Medical Insurance). Because you must pay a premium for Part B coverage, you can turn it down. However, if you decide to enroll in Part B later on, you may have to pay a late enrollment penalty for as long as you have Part B coverage. We suggest that individuals speak to their health benefits advisor, or health plan representative 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, and read our publication “Apply Online for Medicare – Even If You Are Not Ready to Retire“. We hope this information helps!
Brenda D.
I turn 65 in June and cannot find where to sign up for Medicare
Casey H.
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Mary A.
My husband was employed/insured & received Medicare in Nov 2017 & chose only part A. in Dec 2017 was diagnosed with cancer again & accepted Hospice care in Jan 2018. can he now add part B & D?
Ray F.
Thank you for your question, Mary Ann. If your husband was actively working and had other health coverage based on that employment, he may qualify for a Special Enrollment Period (SEP). For more information about Medicare visit their website at http://www.Medicare.gov. We hope this information helps.