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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Claire W.
I set up Medicare ,but I am waiting to get my # before I can enroll in secondary. Is there any way I get my #?
A.C.
Hi, Claire. If you still need a replacement Medicare card or immediate proof that you have Medicare, you can take care of both online by creating a personal my Social Security account. We hope this helps.
Marjorie C.
My husband Kenneth Sawyers *** – ** – *** and I – Marjorie Sawyers *** – ** – *** – will be applying for Medicare Part B eff March 1, 2020.
Please provide a pdf of form CMS 40-B to the email below.
Thank you.
A.C.
Hi, Marjorie. Please visit Medicare’s website to access Medicare Part B forms here. Thanks!
Deborah L.
Can we change our PCP throughout the year?
A.C.
Hi, Deborah. Unfortunately, your question is a bit more complex than we can handle in this forum. For your 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 your local Medicare SHIP (State Health Insurance Program Coordinator) to discuss your options. We hope this helps.
N S.
I’ve been trying to disenroll from part B for months. Why don’t you have a disenrollment form available on line. I’ve been searching everywhere. I don’t need part B. Gosh, You could make this easier for us.
A.C.
Hi. We are sorry to hear about your frustration. 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 will have to go to your local office, and we will help you submit a signed request for termination or Form CMS-1763. We hope this helps.
Linda N.
I requested a medicare cord so that I can sign up for Medicare in October and I STILL have not recieved it. I am told that I cannot sign up for Medicare with out this card. What do I do about this??? I don’t want to end up paying a penalty just because it took so long to get this card.
A.C.
Hi, Linda. 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.
Paul R.
I need to get the Special Enrolment Documents. I was told that since I am on my wife’s insurance I didn’t need to apply for medicare even though I turned 65 in October. The SSA office told me I need to get two forms in January and have one filled out by myself and the other filled out by my wife’s HR department. My wife retires in March 2020.
A.C.
Hi, Paul. To sign up for Part B in the Special Enrollment Period (SEP), download, complete, and submit the forms CMS 40-B Application for Enrollment in Medicare – Part B and CMS L-564 Request for Employment Information to your local Social Security office. You can find these forms here. We hope this helps.
Diane E.
I do not want to continue to have the PART D pharmacy payment deducted from my Social security check. How can I opt out?
A.C.
Hi, Diane. Unfortunately, your question is a bit more complex than we can handle in this forum. For your security, we do not have access to information about your account in this venue. To get additional information on Medicare benefits, check out http://www.medicare.gov/. You may also wish to contact your local Medicare SHIP (State Health Insurance Program Coordinator) to discuss your options. We hope this helps.
Sharon L.
Can you send me information on how to signup for Medicare now? I have created a social security account already and wish to wait till full retirement age on my benefits. However I would like to signup for my Medicare benefits now.
A.C.
Hi, Sharon. To find more information about Medicare and how to apply, visit here. Thanks!
Jerry M.
I’m still not getting a clear answer of the impact to me for now stopping my Medicare Part B coverage that I I’ve been paying for for over 2 years (while fully employed with their Aetna PPO Medical Plan.)
Please advise.
Thank you.
A.C.
Hi, Jerry. 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. For an interview, 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 go to your local office. Generally, when calling our 800 number, you’ll have a shorter wait time if you call later in the day. We hope this helps.
Tori R.
It’s awesome how you said to take stock of your health status so you know if you need to change something or not. That’ll help you choose the plan that has exactly what you need in it. You’ll be better off if you do just a little bit of research and planning first. https://www.jrs.life/medicare