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. Brad M.

    I have no idea what to do first.
    I will be 65 in May.
    Should I go to my nearest SSA office to learn what steps I need to take?

    Thank You

  2. Bill H.

    Please tell me how to apply Medicare part A

    • V.V.

      Hi Bill. 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 (Part A only or both A&B) online.

  3. Michael L.

    I’m on disability and I live in portlavaca Texas and need to get insurance for dental who would I contact

  4. Paula A.

    Turned 65 on 2/24/19, work full time and pay for full family insurance coverage, do I have to sign up of Medicaid/Medicare by when?

    • A.C.

      Hi, Paula. Hi. Generally, if you or your spouse are still working and are covered under a group health plan based on that employment, you don’t need Medicare part B until you stop working or drop your health care coverage. However, you should speak to your personnel office, health benefits advisor, or health plan to see what’s best for you. To read more about whether you need Medicare Part B, click here. We hope this helps.

  5. Martha A.

    Trying to sign up for Medicare A

    • A.C.

      Thanks for your comment, Martha. If you are already getting Social Security retirement benefits, you will be enrolled in Medicare Parts A and B automatically. However, because you must pay a premium for Part B coverage, you have the option of turning it down. If you are not already getting retirement benefits, you should contact us about three months before your 65th birthday to sign up for Medicare. You can sign up for Medicare even if you do not plan to retire at age 65. To learn more. check out our publication, Medicare. We hope this helps.

  6. Richard E.

    I’m retired Air Force and my wife doesn’t work due to a stoke in 2005 and she’s 65 where to I start first for medicare? I see information that’s available, but I’m confused as to where I should start….help and thanks!

    • A.C.

      Hi, Richard. Thanks for your question. If your wife is already getting Social Security retirement benefits, she will be enrolled in Medicare Parts A and B automatically. However, because she must pay a premium for Part B coverage, she has the option of turning it down. If she is not already getting retirement benefits, she should contact us about three months before her 65th birthday to sign up for Medicare. To learn more about Medicare, visit our Medicare web page. For specific questions about your wife’s case, she can also contact us at 1-800-772-1213, Monday through Friday, between 7:00 a.m. and 7:00 p.m. Generally, she will have a shorter wait if she calls later in the day. We hope this helps.

  7. MARY. L.

    I NEED HELP SIGNING UP MY WIFE ON MEDICARE. SHE HAS. “MS”. AND CAN`T GET TO THE MEDICARE OFFICE.

    HERE NAME IS: MARY L. YATES
    HER SS#. IS. :
    *** – ** – ***

    HER. DOB. IS. :

    04-25-1954

    THANKING YOU IN ADVANCE. “BILL”. YAES. HER. HUSBAND.

    WE ALSO NEED TO KNOW WHAT ADDRESS YOU HAVE ON FILE FOR HER. FOR. MEDICARE.GOV

    • A.C.

      Hi, Bill. For your wife’s security, we do not have access to private information in this venue. If she already getting Social Security retirement benefits, you will be enrolled in Medicare Parts A and B automatically. However, because she must pay a premium for Part B coverage, she has the option of turning it down. If she is not already getting retirement benefits, she should contact us about three months before her 65th birthday to sign up for Medicare. She can sign up for Medicare even if she does not plan to retire at age 65. She can call us at 1-800-772-1213, Monday through Friday, between 7:00 a.m. and 7:00 p.m. to set up a telephone appointment. Or she can contact her local office. We hope this helps.

  8. Annette R.

    My sister is already drawing early Social Security. She turns 65 in September. When will she be eligible to sign up for medicare? (she does not have a computer.)

    • V.V.

      Hi Annette, thank you for your question. If your sister is already receiving Social Security benefits, if she lives 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 her in Medicare Parts A and B.

      If she needs additional assistance, she can call our toll free number at 1-800-772-1213 (TTY 1-800-325-0778) . Representatives are available Monday through Friday, between 7 a.m. and 7 p.m. or contact her local Social Security office.

  9. ORLANDO S.

    I was at the Social Security Office. They indicated that I have not signed up for my Medicare Plan A & B since I turn 65 in May. They asked me to set up an appt for March to go to the Social Security Office and set up with their computer. By doing this I have access to a computer and they have someone to assist me if I have a question. How can I set up an appointment to complete the application at the Social Security Office. I can’t just walk in for access to their computers. Thank you for your help.

    • V.V.

      Hi Orlando, thank you for using our blog to ask your question. 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.

  10. patrick g.

    how can I verify that i properly enrolled for
    Medicare

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