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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Mitchell F.
need instructions to enroll in part b medicare
V.V.
Hi Mitchell, thank you for your question. See our Frequently Asked Questions web page on how to sign up for Medicare Part B.
Gary F.
I will remain employed through January 2, 2019. Employer medical coverage will last until end of January. Do I still need to be enrolled in Medicare Part B by December 7, 2018.
R.F.
Hello Gary. The enrollment period you’re referring to (October 15–December 7) applies to beneficiaries –already enrolled in Medicare Part A & B- wanting to make changes to their Medicare Advantage or Medicare prescription drug coverage for the following year.
You must have Medicare Part A and Part B to join a Medicare Advantage Plan.
If you’re over age 65, and covered under a Group health plan based on current employment, you may be eligible to sign up for Medicare (Part A & B) during a Special Enrollment Period (SEP). 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.
For specific questions about your case, call 1-800-772-1213, Monday through Friday between 7 a.m. and 7 p.m. and ask a representative to assist you, or you can contact your local office directly. Thanks!
Roseann R.
I am employed with a college and was offered medical benefits for my husband and myself free. How do I cancel medicare?
V.V.
Thank you for using our blog to ask your question, Roseann. You can terminate Medicare Part B if you or your spouse are actively employed and have coverage under a group health plan based on that employment. 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. In addition, you should speak to a Social Security representative to ensure you will not encounter penalties later. Please contact your local Social Security office for further assistance or call our toll-free number at 1-800-772-1213. Representatives are available Monday through Friday, between 7:00 a.m. and 7:00 p.m.
Karen J.
I applied for Medicare Part A. I am turning 65 but still employed full time. When completing the online application, I saw a notice that I needed to follow up by mailing in the application. However, I did not see an address and cannot access the information again. I completed the online signature. Do I need to mail in my application?
V.V.
Hi Karen, thank you for using our blog to ask your question. You can check your application status in your my Social Security account. Some of the things that the application status will show are the date we received your application and if a decision has been made.
If you are unable to open a my Social Security account, you can still call 1-800-772-1213 to check your claim status by using our automated system using the confirmation number you received when you filed your claim.
Stephen M.
I enrolled in part A when I turned 65, I am still working and have my employer’s insurance.
I’d like to De-enroll in Part A so that I can participate in my employer’s Health Savings Plan.
Can I do that and re-enroll just before I retire?
Gan X.
I am a college professor, will be 70 in March 2019. I am going to continue teaching. The HR Officer at my college told me that I do not have to have the Medicare since I am covered by the college faculty medical insurance. That was why I did not enroll in the Medicare Plan B 5 years ago.
One thing worries me: Do I have to pay the late enrollment penalty when I retire after I am 72 or 73?
Please help me. I have a Ph.D. degree, there are too many rules related to Medicare and I am confused, even to one who has been in 3 graduate schools.
Thanks for your time and help.
My email:
V.V.
Hi there. Thanks for your question. If you are covered under a group health plan based on your current employment, you may qualify for a Special Enrollment Period (SEP).
Check out our Frequently Asked Questions web page for more details.
You can also read the information about general and special enrollment periods in the “Signing up for Medicare” section of our “Medicare” booklet.
Beth
Hey, On your website I see lots of information, but not yet the place I need to sign up, so I can make my choice now that I am 65.
beth Locke
V.V.
Hi Beth, thank you for your question. You can apply online for Medicare even if you are not ready to retire. Use our online application to sign up for Medicare. It takes less than 10 minutes. In most cases, once your application is submitted electronically, you’re done. There are no forms to sign and usually no documentation is required. Social Security will process your application and contact you if we need more information. Otherwise, you’ll receive your Medicare card in the mail.
You should sign up for Medicare three months before reaching age 65, even if you are not ready to start receiving retirement benefits. You can opt out of receiving cash retirement benefits now once you are in the online application. Then you can apply online for retirement benefits later.
With our online application, you can sign up for Medicare Part A (Hospital Insurance) and Part B (Medical Insurance).
If you are unable or choose not to file online, you can also make an appointment by calling us at 1-800-772-1213 from 7 a.m. to 7 p.m. Monday through Friday. If you are deaf or hard of hearing, you can call us at TTY 1-800-325-0778.
Thomas W.
I like how you said that you need to take stock of your health and see if you need to change the plan that you have. Getting in touch with a Medicare general agency would probably be a good way to figure out if you should change or not. That way you can save some money and get things in a way that will allow you to always be healthy.
https://financialgrade.com/contracting-opportunities-with-financial-grade-senior-consultants/
RAEJEAN G.
I am inquiring about how to receive SEP forms for my employer to fill out as I am planning on retiring in a few months.
scott c.
HI do I need to sign up for my medicare part A (hospital insurance) im not going to retire yet.