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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Douglas F.
I will not be getting social security payments until my 66th birthday, June 30, 2020.
I am working full time until January 1. 2020 and have full group medical coverage from my employer through December 31, 2019.
I need to fill out the form for the Special Enrollment Period, but cannot find the forms int eh hundreds listed on your site. Please provide the exact CMS form
John M.
Trying to remain covered by my spouse’s insurance until I receive my Medicare card. So approximately how long will it take to get my Medicare card after all documentation has been turned in? Also how will I pay for the premium I was told I would be charged for Part B? I will not be receiving benefits until I am 66. Will turn 65 on July 24, 2019. Submitted documents around 6/6/19. Thanks!
A.C.
Hi, John. Thanks for your questions. The length of time it takes to process an application can vary depending on whether we need to verify documents or other personal information. Unfortunately, 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. Also, keep in mind, if you do not get Social Security payments, Railroad Retirement Board (RRB), or Civil Service benefits, you’ll get a bill called a “Medicare Premium Bill” (CMS-500) quarterly. We hope this helps.
Ann S.
I’m a retired Federal Employee and have my Federal health care through Kaiser, which doesn’t require that I have Part B Medicare. I have only Part A.
If I chance my health care to another company that requires Part B, what is the penalty for late sign up if any.
Thank you.
Steven S.
I have signed up for social security insurance but don’t know how to have my supplemental medical insurance paid from my social security payment.
Dennis E.
I am not 65 years old until Dec 8, 2019. Do I need to enroll in Medicare when I am “NOT” entitled to my social security check until I am 66. Why can’t I enroll in Medicare in 2020? And do I “have to” enroll in Medicare (Parts B C D)?
My primary question is do I have to enroll in Medicare this year?
David D.
Can I apply for Medicare without applying for my Social security benefit.
A.C.
Hi, David. We advise people to file for Medicare benefits three months before age 65 – even if you plan to continue working. For more information and to file, visit our Medicare Benefits web page. We hope this helps.
Beth
I just got a bill for Medicare part B. If I’m covered by my husbands insurance, do I need to get part B? If not, how do I drop part B?
If my husband stops working, in the next few months, how can I reapply for it, on the phone or at the SS office.
A.C.
Hi, Beth. 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. If you wish to terminate your enrollment, a signed request for termination and a personal interview is required. You will have to go to your local office. You can also discuss what your options are for signing up for Medicare Part B later. We hope this helps.
Jerry S.
I will be turning age 65 this and I will be eligible for medicare. However, I will not draw my full benefit social security until I turn age 66 due to the age benifit timeline
being move on individual born after 1954. how do I pay for the preminium on part B.
Marie M.
I received a letter dated May 31, 2019 stating what my amount will be after Medicare part B is taken out. The usual amount is $135.00 a month, but being I did not get this at 65 I am paying a penalty totaling $243.90. How much is the penalty first of all, and for how long will I be paying this amount. I am now 74 years old. I was told it would be a small amount. This is not small. How big is the penalty. My amount goes way down. Not possible to make it. Wow, I am stunned.
A.C.
Hi, Marie. We apologize, but your question is a bit more complex than we can address in this forum. 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.
Margaret E.
I would like to be able to get forms needed to apply for Medicare part B on line. Could you please send forms CMS 40 B and CMS L564 to me at this email address
menigon@fcps.edu Thank you
Margaret E. Nigon
A.C.
Hi, Margaret. If you already have Medicare Part A and wish to sign up for Medicare Part B, please contact your local Social Security office or call our toll-free number at 1-800-772-1213 (TTY 1-800-325-0778). Representatives are available Monday through Friday between 7:00 a.m. and 7:00 p.m. Generally, you’ll have a shorter wait time if you call later in the day. Just a reminder – please be cautious about posting personal information on social media. We hope this helps!