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. tonya

    hello, I will have my disability benefit 2 years in February. how and when do I sign up for my medical? I was told I had to wait 2 years. thank you

    • A.C.

      Hi, Tonya. Thanks for your question. If you are receiving Social Security Disability, you will receive Medicare after you receive disability benefits for 24 months. We will automatically enroll you in Medicare. We start counting the 24 months from the month you were entitled to receive disability, not the month when you received your first check. For specific questions about your case, and when your Medicare begins, you can call 1-800-772-1213, Monday through Friday between 7:00 a.m. and 7:00 p.m. and ask a representative to assist you. Generally, you’ll have a shorter wait time if you call later in the day. Since you have not reached 24 months, you may be eligible to receive social services from the state in which you live. These services include Medicaid, free meals, housekeeping help, transportation or help with other problems. To find out whether you may qualify and if you need to file a separate application, call the Centers for Medicare & Medicaid Services at 1-800-633-4227 (TTY, 1-877-486-2048). You also can get information about services in your area from your state or local social services or welfare office. We hope this helps!

  2. Robyn F.

    I’m already on SS Disability and am on Medicare A & B I will be 65 Dec.31st,2019 do I need to sign up for regular retirement?

    • A.C.

      Hi, Robyn. Thanks for your question. When you reach full retirement age, your disability benefits automatically convert to retirement benefits, but the benefit amount remains the same. We hope this helps.

  3. exceedhealthcareuk

    Health is wealth. so for your older age person you really need some care taker to take care of your old persons in your family.if you have Healthcare recruitment then Get Friendly and reliable carers and domestic care assistants from the agency https://www.exceed-healthcare.co.uk/health-care-recruitment

  4. DENISE O.

    I am 64 and already receiving my social security checks. I will be 65 on March 5, 2020. Do I need to enroll in Medicare or will my Medicare be automatically deducted from my social security check each month and how much will be deducted? If I need to enroll in Medicare when do I enroll and when is the deadline? Is Medicare A free and how much is Medicare B?

    Thanks!

    • L.A.

      Hi Denise. Thank you for your question. If you are already getting Social Security retirement benefits, you will be automatically enrolled in Medicare Parts A and B. Part A is free, and for Part B there is a month premium. To learn more about Medicare go to our Frequently Asked Questions and see our publication titled “Medicare.” We hope this helps.

  5. Antonio E.

    During last enrollment I signed up for Dental, Hearing and Vision coverage. Now I’m getting letters from my
    insurance company BCBSMedicare Advantage that there was no coverage for the dental work,on the dates the procedures were performed. It was my understanding that the premiums I have been paying were for this additional coverage. Please confirm my benefits for Dental, Hearing and Vision.

  6. antonia b.

    IM UNDER MY HUSBAND MEDICAL INSURANCE DO I HAVE TO TAKE MEDICARE PLAN.OR CAN I DO IT LATER.I KNOW I GET PENALYSI.OR CAN I GET 1 PART….THANK YOU

    • L.A.

      Hi Antonia. Thank you for your question. If your spouse is still working and you are covered under a group health plan based on that employment, you may not need Medicare Part B until your spouse stops working or your spouse’s employer says that it is going to stop your health care coverage. You should speak to your spouse’s employer or to the health insurance plan to see what is best for you. You can read more about whether you need Medicare Part B on our internet page. We also recommend that you read our publication titled “Medicare” for more information. We hope this helps.

  7. Thomas m.

    How can I have part b to my Medicare

    • A.C.

      Hi, Thomas. Thanks for the question. Medicare Part B is medical insurance that helps pay for doctors’ services and many other medical services and supplies that hospital insurance does not cover. If you already have Medicare Part A and wish to sign up for Medicare Part B, you should contact your local office. You can also 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’ll have a shorter wait time if you call later in the day. For additional information about Medicare, read our Medicare publication here. We hope this helps.

  8. Jane A.

    I just recently was approved for social security disability. First payment will be November 20, 2019. I have two questions. When will I receive the back payments from the date I was unable to work which was April 2019?
    Second question: I am 59 years old. When will I be eligible to receive Medicare? Do I have to wait until I am 65 even though I am on disability?

    • A.C.

      Hi, Jane. 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.

  9. Joseph C.

    My husband will start s.s. retirement in Dec. 2019. Can he get medicare and quotes on some health insurance plans? Thank you

  10. Margaret M.

    I need an English version of form CMS 40B send to my email address listed below. The copy I received was in Spanish, Thank you

Comments are closed.