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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Marie M.
I read the booklet that came about my enrollment time for medicare. It says, if I am already receiving Social Security, I will automatically get my medicare card in the mail. I have selected my plans, but have not received my card yet and cannot sign up for plans until I have it. Is this correct that it will be mailed to me? I’m already in my second month of elidgeability.
V.V.
Marie, thank you for your question. If you already get Social Security benefits, we’ll automatically enroll you in Medicare Hospital Insurance (Part A) and Medical Insurance (Part B). We’ll mail you all the information you need a few months before you become eligible. If you haven’t received your Medicare information, please call us at 1-800-772-1213 (TTY 1-800-325-0778) 7 a.m. to 7 p.m., Monday through Friday to speak to a representative or visit your local Social Security office.
Lynell H.
All I want to know – confirm – is if at age 65 and I’m still employed, covered by my employer’s group health plan do I HAVE to sign up for Medicare?
V.V.
Hi Lynell, 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.
Faith M.
I will be 65 years old on September 29, 2020.
What do I need to do today?
Elaine M.
Hello, I will turn 65 on July,29 2019….I don’t see any way to apply for Medicare online….I want to apply online….please advise me on how to do this or is it easier to go to the SS office….please advise thanks
A.C.
Hi, Elaine. Thanks for your question. 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 here even if you do not plan to retire at age 65. We hope this helps.
Cassandra R.
Do I need to keep Medicare if I’m now married and have blue cross and on disability
V.V.
Hi Cassandra, thank you for the question. People who receive Social Security disability benefits and are covered under a group health plan from either their own or a family member’s current employment may qualify for 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.
Monica K.
once medicare premiums are deducted from the social security benefits, is it for the next month or the current month?
V.V.
Hi Monica, thank you for your question. Although Social Security benefits are always paid a month behind, Medicare premiums are for the month they are withheld. For example, if your Medicare begins in June, your Medicare premium is automatically withheld from the Social Security benefit paid in June.
Catherine H.
My husband is a veteran, has va healthcare, got a medicare advantage plan when he first was eligible (last year), but realizes that he really doesn’t need it. How does he cancel his plan B?
L.A.
Thank you for your question, Catherine. Before your husband decides to cancel his Medicare Part B, you should know that current law requires TRICARE (VA Healthcare) beneficiaries who are entitled to Medicare Part A to enroll in Medicare Part B to retain their TRICARE benefits. Please visit the TRICARE web page or contact your military health benefits adviser for more information. We hope this information helps.
Michael S.
Need to know more about options for signing up for
Medicare part B.Is there a time limit when you need
Or have to sign up ?
Momin A.
I’m enrolled in Medicare Plans A & B, but does it cover dental? If not, does medicare cover dental?
Jacqueline L.
I would like to stop my Medicare Medical Insurance deductions from my check each month. Because for the last 2 years I have been covered under his health plan at his job. And have not even used your plan at all I really would like it to stop but I don’t know how to do it. Could someone please help me with this matter. THANK YOU
A.C.
Hi, Jacqueline. Thanks for your comment. 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. Generally, when calling our 800 number, you’ll have a shorter wait time if you call later in the day. We hope this helps.