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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gloria R.
Currently we have a medical advantage plan..have had a medical advantagr for ten years. Am considering a change to medicare and suppliment. Can I/ we do this? Qualifications?
R.F.
Hi Gloria! You should contact Medicare directly at 1-800-633-4227 to discuss your question.
clementine s.
Hello, Iam really frustrated about the A&B premiums payment each month, I am unemployed and really aren’t getting enough in Social Security
payment each month,I will be 65 in Dec. and got to
pay the premiums.Can’t afford anything else.Could we get an increase on the benefits? This will help a
whole lot. Thanks!
R.F.
Clementine, we are sorry to hear of your difficulties. By law, there will be no Cost-Of-Living Adjustment (COLA) increase for Social Security beneficiaries in 2016. The following information may help: You may qualify for Supplemental Security Income (SSI) payments at age 65. SSI is a needs based program that gives cash assistance to people with limited income and resources who are age 65 or older, blind or disabled.. Please call us at 1-800-772-1213, Monday through Friday, between 7 a.m. to 7 p.m. for more information. Generally, you will have a shorter wait time if you call later in the week. Also, you may be eligible to receive social services from the state in which you live. Medicare enrollees who have limited income and resources may get help paying for their premiums and out-of-pocket medical expenses from Medicaid. Please call the Centers for Medicare & Medicaid Services at 1-800-633-4227 for more information.
Elizabeth R.
I just found out today that my Medicare Part B was cancelled. I am in Texas for cancer surgery, something I can’t put off while officials are dealing with whatever red tape caused this debacle. I mailed off my Part B Medicare payment over 10 days ago (something I have to do myself until social security finally starts sending me survivor benefits that I have been trying to get for months now, at which time I can just have it taken out of my social security check).
In the meantime, what am I supposed to do? I was on the phone
all day today with Medicare, United Health, and Social Security trying to get this mess straightened out. SS and Medicare both had their systems down, so they could not even check to see if and when my payment posted.
Looks as if I will have to pay for my entire surgery out of pocket. I can’t afford to put it off.
Any advice out there?
Elizabeth
R.F.
We are sorry to hear about your situation, Elizabeth. Unfortunately, we will need some processing time to reinstate your Medicare benefits after we receive your payment in the mail. Please continue to work with your local office, and if necessary, ask to speak with the manager to see how we can help to expedite your request. If you are unable to visit the local office, you can call our toll free number at 1-800-772-1213 (TTY 1-800-325-0778. Representatives are available Monday through Friday between 7:00a.m. and 7:00p.m. Generally, you will have a shorter wait time if you call later in the week.
Christa A.
I did a lot of passwords and username to get to the Social Security on the computer, but I cannot go there now.
R.F.
Hello Christa! If you are having difficulties with your personal my Social Security account, please call 1-800-772-1213 for assistance. After you hear “Briefly tell me why you are calling,” say “Help Desk” for help with a my Social Security account. Sometimes, it might be best to visit your local Social Security office for further assistance.
Sagar
You’ve magenad a first class post
Christa A.
I will be 65 years old on Dec. 19, 2015, and of course I will have the Medicare coming already at the beginning of December. I guess I will have $104.90 from my social security. I also guess that the $104.90 will be every month from Medicare. Please give me a day where I can go to Social Security in Show Low ,AZ.
Thank you, Christa Lemons
R.F.
Congratulations on your upcoming 65th birthday Christa! If you receive Social Security benefits, we will automatically deduct the Medicare Part B premium from your monthly payments. Please read our publication about Medicare benefits for more information.
shashi
I am delaying my SS 9 month. Is it possible not to enrolled in Medicare part A and B? I have born in Aug.1950. I am still working for large company and getting insurance coverage thru my Employer for myself and spouse. I have not enrolled in Medicare PART A and B at all. I have not applied social security benefit up till now. My spouse born in Jan 1957. She did not work at all. I am contributing in HSA plan thru my employer.
My question is if I apply for SS in Feb. 2017. Do I have option to start my benefit 6 month delay benefit or restorative benefit from last 6 month? In delay benefit option when my Medicare starts. I don’t want six month back start my Medicare. I want to avoid any penalty since I am contributing in HSA at the same time Medicare enrolled. I heard that as soon as you enrolled in SS benefit Medicare kick back up to 6 month
R.F.
Hi Shashi, we generally allow up to six months of retro-activity payments for retirement benefits, only after the applicant has reached his or her full retirement age. No retroactive benefits are payable for any month before individuals reach their full retirement age. As for Medicare, If you are 65 or older and not ready to start your monthly cash benefits yet, you can use our online retirement application to sign up for Medicare Part A ONLY and apply for your retirement benefits later. If you are actively working and covered under your 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 always suggest that individuals speak to their personnel office, health benefits advisor, or health plan coordinator 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.
Ofelia l.
My husband had very severe stroke and He is now in wheelchair , He lost part of his movements and he is not able to walk , He is losing his mind .. He was paying Medicare premium part A -B once a year . last payment was (596.40 ) . Can you pleas to help me to find if He needs to continuo paying his premium ensurance and how much is for next year, and when we have to pay and where. Thank you.. Ofelia Lawrence
R.F.
Hi Ofelia, we are sorry to hear about your husband’s medical condition. First of all, it sounds like your husband will need help managing his Social Security benefits. If you or another relative are interested in applying to become your husband’s representative payee, you will need to contact your local office for a face-to-face interview. As a representative payee, you will be able to talk with us and have access to your husband’s records. In the future, it will make it easier for you to update his account information. We understand how inconvenient this may be, but we hope that you understand our role in protecting everyone’s personal information. If you have specific questions, or to make an appointment, please call 1-800-772-1213 (TTY 1-800-325-0778) between 7 a.m. to 7 p.m. to speak to one of our representatives. Generally, you’ll have a shorter wait time if you call later in the week.
carlos r.
can someone help me to opt out of medicare. i live in mexico full time and is not feasible fo rme ane time soon
R.F.
Thank you for using our blog Carlos. In order to terminate or opt out of Medicare part B, a signed request for termination and a personal interview are required. Medicare generally does not cover health care while you are outside of the United States, but you may still want to discuss your options. Please contact your local U. S. Embassy or Consulate for assistance.
Marion G.
I am 65 years old. I’ll be 66 in December. I get retirement benefits via Social Security. I have Medicare parts A & B. Also, Part D. I need additional coverage. The older I get, the more I need doctor’s care. Sometimes, I pay a co-pay, sometimes I need to consult specialist. Should I get additional coverage for specialist ?
R.F.
Hi Marion. You should contact Medicare directly at 1-800-633-4227 to discuss your question.
R.F.
Hello, if you have Medicare coverage combined with another health insurance program and if you find that your current coverage still meets your needs, then you don’t need to make any changes. You should always check with your health benefits advisor, or health plan representative to see what’s best for you. You can also visit http://www.Medicare.gov for more information.
Dean W.
As retired USAF, I’ve had Medicare A & B for several years, plus Trycare-for-life. I’ve had several mild strokes and open-heart surgery and everything was covered-and-paid-for.
Is there anything I need to do in order to keep my total coverage?
mel m.
I’m also retired military. I have Medicare(primary) and Tricare for life(secondary). Does open enrollment apply to me if I’m happy with what I have?
R.F.
Hello Mel, if you have Medicare coverage combined with another health insurance program and if you find that your current coverage still meets your needs, then you don’t need to make any changes. You should always check with your health benefits advisor, or health plan representative to see what’s best for you. You can also visit http://www.Medicare.gov for more information.
R.F.
Hello Dean, if you have Medicare coverage combined with another health insurance program and if you find that your current coverage still meets your needs, then you don’t need to make any changes. You should always check with your health benefits advisor, or health plan representative to see what’s best for you. You can also visit http://www.Medicare.gov for more information.
Georg L.
I am happy with my 2015 coverage. Will that automatically renew for 2016 or must I do something more. I have reviewed all the recommended steps
R.F.
Hi George! Please contact Medicare directly at 1-800-633-4227 to discuss your question.