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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James w.
Can I drop part D coverage if I have part D on my Humana plan?
L.A.
Hi James. We strongly recommend that you contact Humana and Medicare, 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048) before making any decision to terminate coverage. We hope this helps.
L.A.
Hi James. For your security, we do not have access to your personal information in this forum, and your question is a bit more complex than we can handle in this venue. To get additional information on Medicare premium payments, please visit Medicare’s internet page. You may also contact your local Medicare SHIP (State Health Insurance Program Coordinator) to discuss your options. We hope this helps.
James C.
I just turned 65 in November of 19
Im a school teacher still working full time.. My health insurance is on my 65 year old banker wifes health insurance since the cost is less with her company than mine.
QUESTION–
What do I HAVE TO DO right now? do I sign up for Medicare A or simply do nothing and wait till I decide to retire?
Do I have to go on your site and register that Im 65….
Im just lost on what to do.. I must have had 200-300 phone soliciters from all over American call and try to get me to sign up for things…
I simply dont know what to do since im still working full time… some tell me to find out what im currently paying for my health insurance, and then see what part A and Part B cost then buy suppliments for the overage and all is covered, where as what I have I have a 2000 deductible and coinsurance of about 7500 or so to account for if i need it…
im just so lost on what to do..
can you give me a number to call or who to call for answers? my wife tells me I MUST register before the 7th or else bad things happen and cost more in the future…
Thank you for any and all help
Jimmy Crainer 979-235-9189
freeport texas
L.A.
Hi James. Thank you for your question. Since you are age 65 you and still working, you have the choice to delay signing up for Medicare if you are also covered under a group health plan based on your employment. Please speak with your employer and health insurance plan to see what is best for you. You can read more about Medicare coverage in our publication titled “Medicare.” We hope this helps.
Tamar B.
I asked a specific question and it was no answered. This was not helpful.
My question was: Do I need to sign up for Medicare/SS while I am still working after the age of 65?
L.A.
Hi Tamar. Please note that if you are still working and covered by group health insurance from your employer, you may not need to enroll in Medicare. But, you should consult with your human resources administrator and your insurance company to see if they require that you enroll in Medicare. The Law makes a provision for people who are working and covered by group health insurance called “Special Enrollment Period.” We also have a publication titled “Medicare” that may help you better understand how Medicare works. We hope this helps.
PEGGY G.
My husband is in prison can I his wife of 26 years draw in S S at my age of 59. He is 62 .Thanks for Your help .
L.A.
Hi Peggy. Thank you for your question. Please note that you have to be at least age 62 to receive benefits as a spouse under your husband’s earnings record. Also, you husband has to file a claim for the benefits, unless you are divorced, in which case you can file a claim for the benefits as a divorced spouse at age 62. Please visit our Retirement Planner: Benefits For You As A Spouse for more information. We hope this helps.
Gifford T.
I am still working and enrolled in plan B because I was told I would face a penalty if I did not enroll within a six month window when I turned 65. Now I need to know how to hold off on medicare plan B until I quit working. I can find nothing on the medicare web site.
L.A.
Hi Gifford. Thanks for your comments. If you are still working, and are covered under an employee group health plan based on that current work, you may qualify for a Special Enrollment Period (SEP). We hope this helps.
David G.
May a person who receives SSI be enrolled in Medicare?
A.C.
Good question, David. Even though an individual receives SSI, this does not automatically qualify them for Medicare. Generally, people age 65 and older who have worked long enough can get Medicare, but there are also other ways to qualify. For more information, read our publication about Medicare here. We hope this helps.
Christi N.
Seattle SSA office address zipcode is 98107 NOT 47 as on your medicare mail in documents and visit office page. Hope you can correct ASAP.
Jan M.
Can you add a link to the top of this page entitled
“Open Enrollment”
I don’t know if “signing up for Medicare” and “Open Enrollment” are the same thing.
Jeffrey S.
GM. What is the form that I need to apply for Part B for proof of health insurance coverage by my employer? I know Human Resources has to sign and fill the form out and I will take it to the local SSI Office along with SSA-44.
Thank You
Jeffrey Smidga
L.A.
Hi Jeffrey. Good news! If you are at least 65 years old, you can apply online for Medicare coverege. We hope this helps.
Patricia O.
What do I need to do in order to sign up for medicare?
L.A.
Hi Patricia. 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 when you turn 65. However, if you are receiving Social Security disability benefits, you will be automatically enrolled 24 months after you started receiving the disability benefits. If you are not receiving Social Security benefits and you are at least 65 years old (or will be within the next three months), you can use our online application to enroll in Medicare. To learn more about Medicare go to our Frequently Asked Questions, and see our publication titled “Medicare.” We hope this helps.