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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Alan H.
I’ve setup a Social Security Account and Applied for Medicare Part A. I was told that since I’m still working a couple of more years I would sign up for Part B when I retire and wanted to confirm this was correct. I work for the Defense Contract Audit Agency (DCAA) Federal Blue Cross Blue Shield Health Plan currently. Also, I have not received any mail correspondence for written signature.
V.V.
Hi Alan. 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!
Jae H.
I need to know to enroll in Medicare because I will be 65 years old on March 14, 2019. Please inform me.
R.F.
Hello Jae. If you are eligible for Medicare 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 or spouses benefits later.
If you already get Social Security benefits, we’ll automatically enroll you in Medicare Hospital Insurance (Part A) and Medical Insurance (Part B). However, because you must pay a premium for Part B coverage, you have the option of turning it down.
Also, if you’re actively working and you are covered under an 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 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. 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 Social Security office directly.
We hope this information helps!
Farzad K.
I will be 65 in May 2019. Do I need to register for Medicare?
Eric M.
I reach age 65 on 1 Feb 2019. I’m retired Air Force and have Tricare. I am not going to apply for social security until age 70, and I’m currently working and my employer’s Medical plan offers Tricare Suppliment, which I pay for. How does this effect my signing up for Medicare part B?
Carol L.
When I attempt to enroll in Medicare online, it kicks me off as “unable to process this account now.” Please advise! I spoke with a rep & she helped me reset my password etc, but it still will not allow me to complete the process of enrollment! I am eligible beginning February 1, 2019.
V.V.
Hi Carol, thanks for using our blog. If you are unable to apply online, you can schedule an appointment by:
•Calling us at 1-800-772-1213 (TTY 1-800-325-0778) between 7 a.m. to 7 p.m., Monday through Friday; or
•Contacting your local Social Security office. Thanks!
Theodore C.
Looking for feedback on “special enrollment” with termination of an employer HSA health insurance coverage. Spoke to a Medicare help line last month and was told I would be entitled to special enrollment as of 1/1/19. I believe the termination of the HSA should qualify for this type of enrollment. BUT when I attempted to enroll via social security phone enrollment was told I was misinformed and would need to pay penalties. Can you clear this up for me?
V.V.
Hi Theodore, thank you for the question. 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!
Jacqueline L.
what if my husband has insurance threw his job and I wanted to stop my coverage threw SSD how does that work ??
V.V.
Hi Jacqueline. Thanks for your question. If you are covered under a large group health plan based on your spouse’s 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.
Vicki D.
If I am working and plan to work until after I am 67, do I have to sign up for Medicare Plan A?
I signed up for Plan A two weeks ago because I thought I had to. But, I loose the contribution to my HSA.
How can I keep my HSA and still contribute to it?
V.V.
Hi Vicki, thank you for your question. To terminate your enrollment, we will help you submit a signed request for termination or Form CMS-1763. The Centers for Medicare & Medicaid Services (CMS) requires, when possible, a personal interview be conducted with everyone who wishes to terminate entitlement. Therefore, we do not offer form CMS-1763 online. For an interview, you can call us at 1-800-772-1213 (TTY 1-800-325-0778) 7 a.m. to 7 p.m., Monday through Friday or go to your local office.
Patricia S.
If I refused part B, and sent my Medicare card back, should I still call Social Security to tell them this so I don’t have a few when I try to reinstate it at a later date?
R.F.
Hello Patricia. Generally, you will only need to sign and return the Medicare card with the indication that you want to decline Medicare Part B.
It’s very important to keep in mind that a beneficiary may refuse Medicare Part B, during his or her Initial Enrollment Period, if that beneficiary 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 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.
For further assistance, call our toll free number at 1-800-772-1213, Monday through Friday, between 7 a.m. and 7 p.m. Thanks!
Jill S.
changing supplement insurance company and the new supplement insurance company is demanding my social security number along with my medicare health insurance number. my question is, am I required to give the insurance company my social security number?
R.F.
Hello Jill. Generally, Medicare providers need to know your Social Security number in order to provide you the benefits to which you are entitled. They only have to see and verify your Medicare information at the time they provide initial medical services.
The Medicare program, is managed by the Centers for Medicare & Medicaid Services (CMS), you may want to contact them about your concern. Thanks!