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. Adriana H.

    Can we apply on line for Part B, if so what information is needed

    • L.A.

      Hi Adriana. Thanks for your question. It sounds like you already have Medicare Part A, and now want to add Medicare Part B. If you already have Medicare Part A and wish to sign up for Medicare Part B, please complete form CMS 40-B, Application for Enrollment in Medicare – Part B (Medical Insurance), and take or mail it to your local Social Security office. Before you do, here’s some information on enrolling in Medicare Part B to assist you with your inquiry. If you are still working and are covered under a group health plan based on that employment, you may not need Medicare Part B until you stop working or drop your health care coverage. You should speak to your personnel office, health benefits adviser, or health plan to see what’s best for you. Our publication titled “Medicare” can provide you with more information. If you are not currently covered under a group health plan, and apply for Medicare Part B after age 65, you can sign up only during the general enrollment period (GEP).The GEP runs from January 1 through March 31. Your Medicare coverage would begin July 1. Some people who sign up for Part B during the GEP will have a 10 percent increase in monthly premiums for each 12-month period they did not enroll, but were eligible. 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. We hope this helps.

  2. marie w.

    my husband is turning 66 in February and he never signed up for medicare ,what do we do now

  3. Marva G.

    I am not finding specific information about what Medicare part B covers and it’s deductibles….please tell me where I can find

    • A.C.

      Hi, Marva. For information about what Medicare covers, visit Medicare’s website here. We hope this helps.

  4. cory k.

    tell me why we are not offered dental in arizona for my wife is social security disability , and i am 70% disabled vets no dental and no help with payment . must be 100% disabled vets to get dental . We need help

  5. Karen C.

    Hi, I’m 67 and collecting my social security at 66 4/12/18. I believe I did sign up for Medicare plan A because I’m still working and pay for insurance through my employer. I was asking do I need to change from plan A and when do I need to start paying for Medicare? When I stop working or before. Going to try to go another year of working. thanks so much Karen

  6. Mary

    I have never worked I’m a house wife and mom we have filed jointly since 1975 my husband filed for Medicare only last June when he turned 65 waiting to retire at 70 I am turning 65 in October when I try to file for Medicare only online the site refuses me it wants me to take social security and Medicare together what’s the problem when I called the appointments are two months away

  7. Santos A.

    Hello I’m turning 65 in September however I still going to work until 66, do I need to enroll in Medicare now or can I wait until next year? Do I will be penalize if I do not enroll now? I will be cover under my employer health plan until next year. Thanks.

  8. Michael M.

    I want the forms to opt out of Medicare
    Mc
    Michael Mc Manus
    2420 Henderson, NV
    2402 Worth Ct. 89052

  9. Diane F.

    OK. I did not sign up for Part B but, now I have it and am paying for Part B. I just found out that Medicaid paid my part for me for 3 months and then stopped. Since they were paying my cost, I was enrolled. I am still enrolled and trying to undo it. Social Security said I need to ask Medical (or, Medicad) why they quit paying it for me. I don’t really care, I just don’t want or need part B. When I called Medical they said to go to Social Security. I am a 100% disabled Vet and i wish to not sit in their offices for long periods of time. It is such a strain to arrange transportation and all that is involved. Is there not a form I can obtain to opt out of part B?

  10. DEBORAH P.

    this was not helpful at all. I just want to sign up for part a

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