Medicare

Medicare Open Enrollment: Five Things You Need to Do

November 30, 2015 • By

Reading Time: 3 Minutes

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. Dave M.

    Is it a good idea to sign up for Medicare if I have medical coverage through my wife’s medical coverage. I will be 65 7/7/2019. and if I stay on my wife’s insurance do I notify you three months prior to my birthday. and is their a penalty. thank you for your time

    • V.V.

      Hi Dave, thank you for your question. If you do not want Medicare Part A or B because your wife is actively employed and provides you coverage from an employer group health plan through that active employment, you do not need to do anything. Once she loses that health insurance or is no longer actively employed, whichever comes first, you can enroll in Medicare Part A and B during a Special Enrollment Period (SEP).

      We always suggest that the person carrying the health insurance speak to their personnel office, health benefits advisor, or health plan representative to see what’s best to prevent any penalties or delayed enrollment in the future.

  2. anthony l.

    i would like to enroll in Medicare part A only

    • A.C.

      Hi, Anthony. Individuals receiving Social Security retirement benefits, will be automatically enrolled in Medicare Hospital Insurance (Part A) and Medical Insurance (Part B) at age 65. However, 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. 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. 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. Thanks.

  3. Tomas T.

    HI, I like to ask – I was retired 10/01/2019 , but my health insurance ended 1031/2018. After than I start applying for Medicare plan B. I applied with form CMS40b 2x, but no respond. I do not know what I`m doing wrong, or somebody can tell me what to do. I will be 66 in march 7nt.
    Thank s Tomas Tancar

  4. Sunil T.

    May I please obtain a free booklet on medicare?

  5. Nick K.

    I will be 65 this year and am currently on a high deductible group health plan with my wife and I would like to continue to contribute to my HSA. Do I need to do anything to defer my enrollment to Part A and Part B Medicare? In the future when I decide to enroll, what kind of documentation do I need to provide as proof of insurance so that I do not get penalized?

    • V.V.

      Hi Nick, thank you for your question. If you do not want Medicare Part A or B because you are actively employed and have coverage from an employer group health plan through that active employment, you do not need to do anything. Once you lose that health insurance or are no longer actively employed, whichever comes first, you can enroll in Medicare Part A and 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.

  6. carlos l.

    i will be 65 yeas old in June 11 2019 . when is a go time to apply for medicare for all the parts …..

  7. Gloria S.

    You do not answer the question many retirees have: If I am retired and receive my SS retirement check, I currently have Medicare and do not want to make any changes, must I contact SS every year to re-up with my current basic Medicare?

  8. jeanette r.

    unable to find site to sign up for Medicare Part A. I am currently employed and will be 65 Mar. 3rd, 2019

    • V.V.

      Hi Jeanette. Generally, individuals receiving Social Security benefits are automatically enrolled in Medicare Parts A and B.

      If you are at least 64 years and 9 months old and aren’t receiving Social Security benefits, you can apply for Medicare online.

      If you’re covered under a Group health plan based on current employment, you may be eligible to sign up for both 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.

  9. Beth N.

    Will I be automatically enrolled in Medicare parts A & B, and be sent a Medicare card since I already receive Social security benefits? Or do I have to enroll?

    • V.V.

      Hi Beth, thank you for your question. If you’re already getting Social Security benefits, we’ll send you information a few months before you become eligible for Medicare.If
      you live in one of the 50 states, Washington, D.C., the Northern Mariana Islands, Guam, American Samoa, or the U.S. Virgin Islands, we’ll automatically enroll you in Medicare Parts A and B. However, because you must pay
      a premium for Part B coverage, you can choose to turn it down. Check out the Medicare brochure for more information.

  10. Caden D.

    You are right that with Medicare, you do need to review your plan notices. There may be something new come up to where you would need to know about it. That and you do need to think about what matters most to you as you can pick and choose things with the coverage. https://www.senior-advisors.com/

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