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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Kevin F.
I need to sign up for medicare can’t find right page on line .
A.C.
Hi, Kevin. 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. For more information and to file online, visit our Medicare Benefits web page. We hope this helps.
Vail B.
I currently have Medicare Plan A but will not need Plan B until Feb. 2020. When must I apply? I have gotten a form saying 3/31/19 coverage effective 7/1/19. I am currently covered on Husbands work plan.
Turner L.
I will be turning 65 in july and want to know what is the first thing I need to do and when do I need to start. should I apply for medicare or start to apply for social security?
A.C.
Thanks for your question, Turner. Please bear in mind that the decision on when to apply for benefits is a personal one. We can only provide you with the information to help you make the best choice according to your own situation.
To help you plan, you can use our online calculators. Also, you can create a personal my Social Security account to verify your earnings, and get a copy of your Social Security Statement.
Our system is set up to take applications four months in advance, and when you’re ready, you can apply for your benefits online.
We also advise people to file for Medicare benefits three months before age 65 – even if you plan to continue working. Please read our “Apply Online for Medicare – Even If You Are Not Ready to Retire” publication. When you are ready, you can apply online. If you need further assistance call our toll-free number, 1-800-772-1213 (TTY 1-800-325-0778) and ask to speak with one of our representatives, who are available Monday through Friday between 7:00 a.m. and 7:00 p.m. We hope this helps.
Colleen D.
I called Social Security 800 # and was assured I could since I am 65 sign up for Medicare Part A while still employed with full company insurance and contribute to my HSA. With this advice I signed up for Medicare Part A, please verify the Social Security representative told me correctly – if I was told incorrectly, how do I reverse the decision to sign up for Medicare Part A so I can continue to contribute to the company HSA. Thank you for your time!
A.C.
Hi, Colleen. If you have a Health Savings Account (HSA) and/or health insurance based on employment, you may want to ask your personnel office or insurance company how signing up for Medicare will affect you. If you have any additional specific questions, you can call us at 1-800-772-1213, Monday through Friday, between 7:00 a.m. and 7:00 p.m., for assistance. Generally, you will have a shorter wait if you call later in the day. You can also contact your local Social Security office. We hope this helps.
Lynn E.
Locked out of my account…
phone wait time over 55 minutes.
Need to know if when I should sign up for Medicare B.
I’ve had Medicare A since Aprill 2011; I am anticipating retiring September 1, 2019 currently have health care coverage with my full time employer who has more than 20 employees. DO I NEED TO APPLY BEFORE MARCH 31, 2019 or do I have a 30 day (60 day ) window before/after retirement date???
A.C.
Hi, Lynn. We’re sorry that you had difficulty reaching someone by phone. We may have been experiencing higher than normal call volume. If you are covered under a group health plan based on your current employment, you may qualify for a Special Enrollment Period (SEP) that will let you sign up for Medicare Part B. You have an 8-month SEP to sign up for Part A and/or Part B that starts at one of these times (whichever happens first):
• The month after the employment ends
• The month after group health plan insurance based on current employment ends.
Usually, you don’t pay a late enrollment penalty if you sign up during a SEP. Most individuals contact us at least a month in advance to avoid any lapse in medical coverage. You should always check with your health benefits advisor, or health plan representative to see what’s best for you. To learn more about the Medicare enrollment periods visit http://www.medicare.gov. We hope this helps.
Ha T.
I have enrolled the Medicare through Kaiser. And during the enrollment, I did not quite know the part of dental Advantage-Plus (Delta Dental HMO) was no-so-advantage at all. All those suggested dentists were either not in contract with the group or they are so much farther away from my home address (15+ miles)
I wonder is there a way I can switch to Delta Dental PPO.
I can select my current dentist, who is within walking distance to my home.
V.V.
Hi Ha. Social Security does not administer the Medicare program. Please contact them directly at Medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048).
Sharon K.
Both my husband and I are fully employed and covered under his employer group health insurance plan. I will turn 65 on 3/26/19. What paperwork do I need to fill in prior to that. I don’t need Medicare Part A or B. Thanks,
V.V.
Hi Sharon, thanks for using our blog. If you’re 65 or older, 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. If you choose to wait to enroll in Medicare A & B because you qualify for a Special Enrollment Period, you don’t need to do anything until your SEP.
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!
Margaret R.
I have tried to get Part B for months, as a retired USPS worker I have to go to OPM which was closed (federal office) once opened I sent my form cms-r-297, to opm in Washington two times. As of yet I have no been able to get part B. Can anyone please help!
A.C.
Hi, Margaret. If you are not receiving retirement benefits, you should contact us. Please call us at 1-800-772-1213, Monday through Friday, between 7:00 a.m. and 7:00 p.m. to set up an appointment to file. Or you can contact your local Social Security office. For more information, check out our Medicare publication. Thanks!
Melody W.
I have visited the SSA.gov website as well as the Medicare.gov site trying to find a way of informing that I have part B through my employer. I thought I had provided this information on initial sign up. Letter received saying not signed up for Part B. Did the chat on 2 different times… mis-information. How/where do I find how to notify that I have an employer Part B plan? And for God’s sake, don’t send me to a generic web page.
A.C.
Hi, Melody. For your security, we do not have access to private information in this venue. We ask that members in our Blog community work with our offices with specific questions. You can call us at 1-800-772-1213, Monday through Friday, between 7:00 a.m. and 7:00 p.m., for assistance. Generally, you will have a shorter wait if you call later in the day. You can also contact your local Social Security office. We hope this helps.
Gilbert H.
I currently have full health coverage from my employer.
This coverage will expire 12/31/2019, when should I apply for medicare part B and possibly part D.
I currently have part A.