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. Lou C.

    my wife retired @ 62 & recieves SSI benifits can she get medicare or not till 65?? SSI #*** – ** – *** Stephanie Brachais 751 Los Coches Ave Salinas CA 93906 , we do a joint return my name Louis Casieri (husband) SSI *** – ** – *** . 831 676 3114H ,8317760232 Stephanie’s cell.
    thank you , Lou 831 776 0306c

  2. Benjamin F.

    I am trying to apply for straight Medicare. I currently have Texan Plus HMO. I do not understand how to fill out the forms or what I should do. Please call me back at 936-788-8488

  3. Benjamin F.

    I am trying to apply for straight Medicare. I do not understand how to fill out the forms or what I should do. Please call me back at 936-788-8488

  4. Stephen V.

    I retired at age 62 and went back to work. I turn 65 in December. I received a Medicare Card (A & B) recently.
    I have a good plan through work and don’t need Part “B”. How do I get Social Security to reverse withholding $134 for the Part “B”

  5. Anita M.

    Our application for new will not let us use our original cards! New Medicare cards were sent to our old address. We need the address changed and need to get new cards as our County (Cass) in MN will no longer accept ours!

  6. Rick N.

    I have applied for Medicare online approximately one month ago and need to know why it is taking so long to verify my acceptance. Also, I am told I need to make an appointment to deal with the SS office, but there is nowhere that tells me how to do that. SSA is VERY difficult to deal with. SSA has had many years to figure out how to do it’s work. Citizens are beginners so it should be made easy to understand. No thanks for your assistance.

  7. Yoshiko F.

    My mother wants me to help her renew her Medicare health and drug plan since her checkup revealed that she has to take medicine to lower her blood pressure aside from the insulin shots she has to take. Since you said that one should know the health status first before renewing one’s subscription, it has definitely convinced me to ask both her doctor’s and a medical insurance agent’s cooperation for her plan. Not only will this help my mother get the treatment that she needs but be assured that she will be taken care of as well. https://www.kelleysinsurance.com/medicare

  8. Craig F.

    how do I sign up for medicare. I turn 65 in Feb. 2019.

    Every web site I go to wants me to enroll in medicare secondary plans that I do not need. Can’t I just sign up
    medicare only

    • R.F.

      Hello Craig. Yes, 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.
      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!

  9. Hector M.

    Does open enrollment include Part B enrollment? Aside from the Jan 1 to March 31 Part B enrollment, can there be a special enrollment due to special circumstances (like getting laid off from a job and being forced to retire)?

  10. John X.

    By mistake changed my plan from:
    Welcare Dividend H1032-32-0
    To:
    Blue Medicare Classic (HMO) H1035-019-0

    Spent 3 hours trying to switch back to Welcare. I don´t think I succeeded because no confirmation.

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