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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Ellen
I am 65 on 9-27-18. I have a health plan through my husbands work. He will not retire until 2023. Do I need to sign up for Medicare now?
R.F.
Hello Ellen. A person may refuse Medicare Part B, during his or her Initial Enrollment Period (IEP), if that person or the spouse, actively works and has coverage under a group health plan based on that employment, then he or she doesn’t need Medicare part B until the work activity ends or that health care coverage is dropped.
However, we always suggest that individuals speak to their personnel office, 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.
Individuals within three months of age 65 or older and not ready to start their monthly cash benefits can use our online retirement application to sign up for Medicare Part A -ONLY- and apply for their retirement benefits at a later date.
Individuals already receiving Social Security retirement benefits, are automatically enrolled in Medicare Parts A and B.
To learn more about the Medicare enrollment periods visit http://www.Medicare.gov.
For further assistance, please call our toll free number at 1-800-772-1213. Representatives are available Monday through Friday, between 7 a.m. and 7 p.m. Or you can contact your local office directly.
Hope this information helps!
Sharon K.
Hello,
I just applied for Medicare…is there a separate application for Medicare part B? Or is what I filled out taking care of both?
Bette P.
I work with the State Health Insurance Assistance Program. I read a long time ago that S.S. or Medicare was sending out letters to people approaching age 65, reminding them to sign up for Medicare. We have never seen such a letter and can find no reference to it on any web site. Does it exist? Is the Medicare and You book sent out instead? If so, who receives it and when? People, not just the ones on SS, need a reminder to save them from penalties.
R.F.
Generally, individuals already receiving Social Security retirement benefits, will be enrolled in Medicare Parts A and B automatically at age 65. Individuals not receiving benefits, will need to contact us about three months before their 65th birthday to sign up for Medicare only. You can sign up for Medicare only, even if you do not plan to retire at age 65.
You may want to contact Medicare.gov for more information. Thanks!
Jose M.
Why is it so difficult to find the form to enroll in Medicare part A.
R.F.
Hello Jose, individuals within three months of age 65 or older and not ready to start their monthly cash benefits can use our online retirement application to sign up for Medicare ONLY and apply for their retirement benefits at a later date.
Since you must pay a premium for Part B coverage, you have the option of turning it down. However, 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.
Please read our publication “Apply Online for Medicare – Even If You Are Not Ready to Retire” . We hope this information helps
Kirk M.
I need to make an appointment on October 4th or 5th so That I can enroll in Medicare. My birthdate is January 4th 1954.
I would like to schedule this appointment in Boise Idaho.
V.V.
Thank you for using our blog, Kirk. If you are within three months of age 65 or older and not ready to start your monthly Social Security benefits yet, you can use our online retirement application to sign up just for Medicare and wait to apply for your retirement or spouses benefits later. You can also call 1-800-772-1213 (TTY 1-800-325-0778), Monday through Friday from 7 a.m. and 7 p.m. to make an appointment with your local office.
Individuals receiving Social Security benefits are automatically enrolled in Medicare Parts A and B.
Amy W.
Thanks for pointing out that our state may have programs to help with the cost of Medicare premiums. My mother is turning 65 next month, so I’ve been trying to learn all I can about Medicare. I really appreciate your suggestion to check if you qualify for financial help – I’ll definitely look into what programs are available in my state! https://myseniorhealthplan.com/medicare-plans/how-to-get-medicare/
Jerry u.
What paper work do I need to bring to apply for Medicare in the office?
I already have an appointment.
R.F.
Hello Jerry. We may need to see certain documents when you apply for benefits. See our web page: “What Documents Will You Need When You Apply?” for more information. Thanks!
Lawrence F.
Do I need to have Medicare if I have full health coverage thru my employer.
R.F.
Hello Lawrence. Generally, people age 65 or older, who are citizens or permanent residents of the United States, are eligible for Medicare Part A at no cost. 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 always suggest that individuals speak to their personnel office, 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.
If you are 65 or older and not ready to start your monthly cash benefits yet, you can use our online retirement application to sign up for Medicare ONLY and apply for your retirement benefits later.
To learn more about the Medicare enrollment periods visit http://www.Medicare.gov.
We hope this information helps!
Pamela P.
I saw a reference that since I am still working if I delay applying for medicate It could result in my paying more, but I never found the facts about this.
William R.
My plan D prescription drug supplemental insurance has been canceled for non payment. How can I get reinstated?
I take several medications that are expensive like insulin.
Thanks you
William R Yonker
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R.F.
Hello William. Unfortunately, and because of security reasons we do not have access to personal records in this blog and cannot assist you. One of our representatives should be able to help you in your situation. 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. Generally, you will have a shorter wait time if you call later during the day or later in the week. Thanks!