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

Comments

  1. Gail R.

    I am trying to enroll in medicare part A ONLY
    I have been going from site to site with not luck. I turn 65 in august and was told I need to do this within 3 months of my birthday.

    • A.C.

      Hi, Gail. 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. To learn more about Medicare, check out our publication. We hope this helps.

  2. Lydia A.

    I am trying to disenroll in Medicare Part B as i have a new job that pays 100% of my insurance. I was told i needed to fill out 2 forms
    CMS 40B and have my employer fill in CMSL 564 but i can’t find these forms. Can you help. Thank you

    • V.V.

      Hi Lydia, thank you for using our blog. The forms that you mentioned are required when one enrolls in Medicare during the Special Enrollment Period. To disenroll in Medicare, you need to speak to a Social Security representative. 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.

  3. greg f.

    How does one converse with a human online ?
    I recently attempted to log into my account , which I am not sure I have one . And in the process I hit Forgot my password and that was the end . I was cut off , great system .

    • V.V.

      Hi Greg, thanks for using our blog. Sorry to hear you are having difficulties with your my Social Security account.

      For assistance with your account, you can talk to a representative by:
      •Calling us at 1-800-772-1213 (TTY 1-800-325-0778), Monday through Friday from 7 a.m. to 7 p.m. At the voice prompt, say “helpdesk”; or
      •Contacting your local Social Security office.

  4. Jean P.

    I called to make an appointment to schedule a meeting with someone to provide guidance regarding Medicare which I am to apply for by the end of this month (MAY 2019). A lady called me back & said I should be on the look out for a letter giving me the appointment. I have not received this letter as of this writing.

    • L.A.

      Hi Jean. You may call our toll-free number to find out the place, date, and time of your appointment. Please call 1-800-772-1213 (TTY 1-800-325-0778). We hope this helps.

  5. Denise M.

    Can I file for Medicare through the Social Security Dept.?

    • A.C.

      Hi, Denise. 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 even if you do not plan to retire at age 65. Check our publication, Medicare, to learn more information. We hope this helps!

  6. NORMA B.

    I NEED MORE COVERAGE. I WANT TO CHANGE IT WHEN IT IS OPEN ENROLLMENT TIME.

  7. Robert S.

    how to disenroll due to death

    • A.C.

      Hi, Robert. It sounds like you are referring to reporting a death. Typically, funeral homes report deaths to the Social Security Administration directly. You can check with the funeral home to determine if reporting has been done. Thanks.

  8. E. o.

    I have had much difficulty trying to sign into the account I created. I met with SS representatives twice. The first representative was suppose to correct my address to the address on my Drivers License, but it wasn’t done, or if it was done, the correct address was not reflected on my record 2 days later. The correct address should be: PO Box 337, Carpinteria, CA 93014
    I returned the SS office on May 3, 2019, and learned that the address was still not corrected. I also requested another password. When I came home, I was still not able to sign in, nor create another account. Apparently, there is a problem with the SS “system” accepting the spelling of my name.
    I need assistance in accessing my account so that I do not have to return to the SS office again.

    • A.C.

      Hi. We are sorry to hear about your experience. If you are still unable to access an account or encounter a problem with your personal my Social Security account, you may call us at 1-800-772-1213 (TTY 1-800-325-0778), Monday through Friday from 7:00 a.m. to 7:00 p.m. At the voice prompt, say “helpdesk.” Generally, you will have a shorter wait if you call later in the week. We hope this is resolved soon.
      .

  9. Anne V.

    I am collecting social security benefits. I will be turning 65 in 2 months. Do I need to enroll in medicare or is it done automatically?

    • V.V.

      Hi Anne, thanks 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. Check out our Medicare publication for additional details.

  10. Lorraine G.

    I want to sign up for Medicare Part A only as I am still working and just turned 65 in April. Do I have to sign up for Social Security first to get this started? How do I get signed up for JUST Part A Medicare?

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