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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Doris P.
Did not get an answer!
I would like to know if to apply for Medicare my husband must go to a ssa office or can be done on line? He turns 65 on April 2020
Ann C.
Hi, Doris. Thanks for your question. If your husband is already getting Social Security retirement benefits, he will be enrolled in Medicare Parts A and B automatically. However, because he must pay a premium for Part B coverage, he has the option of turning it down. If he is not already getting retirement benefits, he should contact us about three months before his 65th birthday to sign up for Medicare. He can sign up for Medicare even if he does not plan to retire at age 65. To learn more about Medicare and how to apply, visit here. We hope this helps.
Rick S.
Where do I find the form for my former employer to fill out to prove termination of employment
Ann C.
Hi, Rick. It sounds like you are referring to the Request for Employment Information (CMS-L564). For more information and additional Medicare forms, visit Medicare’s website here. We hope this helps.
sammie m.
I am my sister-in -law’s caregiver. She currently has Wellcare, but she would like to switch back to regular medicare. What do we do?
Ann C.
Hi, Sammie. For your sister-in-law’s security, we do not have access to private information in this venue. To get additional information on Medicare benefits, check out http://www.medicare.gov/. You may also wish to contact her local Medicare SHIP (State Health Insurance Program Coordinator) to discuss her options. We hope this helps.
June H.
I would like a paper copy of the 2020 Medicare and You book. I don’t like looking things up online anymore. My name is: June Henigan
Address: 7252 Moondarra Cir.
Kiowa, CO> 80117
Ann C.
Hi, June. To request a paper copy, please visit Medicare’s website here. Just a reminder – please be cautious about posting personal information on social media. We hope this helps.
Jerry D.
I will be 65 in March. I do not want to receive SS benefits until I am 66. I do need to sign up for Medicare part A. My employer will continue to cover me so I need to refuse part B. Can you give me the correct forms for me to do this? Thank you, Jerry Davis
Ann C.
Hi, Jerry. Eligible individuals should sign up for Medicare three months before their 65th birthday, even if they’re not ready to start their monthly cash benefits. You can use our online retirement application to sign up for Medicare ONLY and apply for retirement benefits at a later date. Since you must pay a premium for Part B coverage, you have the option of turning it down. However, we suggest that individuals speak to their health benefits advisor, or health plan representative to see what’s best for them, and to prevent any penalties or delayed enrollment in the future. To learn more about the Medicare enrollment periods, visit http://www.medicare.gov, and read our publication, Apply Online for Medicare – Even If You Are Not Ready to Retire. We hope this information helps.
Clemens H.
I no longer have part D.
do I still have to pay part D IRMA?
Ann C.
Hi, Clemens. 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.
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Kevin L.
I want to cancel my medicare. I don’t use it, my care come from VA. I have full benefits with them. Thank you Kevin Lipscomb
Ann C.
Hi, Kevin. If you wish to terminate your enrollment, we will help you submit a signed request for termination or Form CMS-1763. The Centers for Medicare & Medicaid Services (CMS) requires, when possible, a personal interview be conducted with everyone who wishes to terminate entitlement. Therefore, we do not offer form CMS-1763 online. You can call us at 1-800-772-1213 (TTY 1-800-325-0778) 7:00 a.m. to 7:00 p.m., Monday through Friday or contact your local Social Security office to schedule an appointment. Thanks!
Allen N.
I have already signed up for a prescription plan. I would like to change my payment form from being billed every month to being deducted from my monthly social security benefit payment. If this is possible please let me know how to do it. Thank You.
Luis A.
Hi Allen. For your security, we do not have access to your personal information in this forum. For specific questions about your account, please call our toll free number, 1-800-772-1213 (TTY 1-800-325-0778), from Monday through Friday, between 7:00 a.m. and 7:00 p.m. You may also contact your local Social Security office. We hope this helps.
Bert H.
My Medicare Advantage Program has cancelled it’s contract as of Jan 1, 2020. I have chosen to enroll in Kaiser Medicare Advantage HMO. My prior payment to Providence Health Care paid from my SSA account should be cancelled.
I will have the new plan put on direct pay from my bank.
Please advise if further action is required on my part.
Luis A.
Hi Bert. Unfortunately, but for your security, we do not have access to private information in this forum. Please call our toll-free number 1-800-772-1213 (TTY 1-800-325-0778) or contact your local Social Security office for assistance. You should also call Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048). We hope this helps.
Luis A.
Hi Bert. 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.