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.
Did you find this Information helpful?
Tags: Medicare, social security, SSA
See CommentsAbout 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
Comments are closed.
brigid o.
I was disenrolled in medicare part b because they did not get my payment on time.
what do I do?
Vonda V.
Hi Brigid, thank you for your question. 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 for assistance or you can contact your local Social Security office. Please look for the general inquiry telephone number at the Social Security Office Locator. The number may appear under Show Additional Office Information. Please be aware that our call wait times are longer than normal. We hope this information helps.
Frank
I am turning 65 in May, I am covered under my wife’s health insurance. She is retired from the VA hospital.
I can not find in any documentation if I can defer signing up for Medicare Part B without incurring the penalty if I sign up later due to loss of insurance coverage through her plan. Everything says if you are covered by your spouses insurance through current employment. No mention of insurance through retirement coverage.
Do I need to sign up for part B now to avoid the penalty should her coverage terminate?
jackson
Glowing testimonials but this didn’t address my search for Form 564. Don’t bother to reply; I’ll find it on my own.
Martha A.
I am seeking info for someone else. She did NOT take Med Part B when she became eligible due to being in receipt of SSDI benefits for 2 years; she is disabled Veteran and thought VA healthcare would be adequate. How can she find out what the cost would be to decide whether to enroll now>
Vonda V.
Hi Martha, thank you for your question. To determine Medicare enrollment and any penalties, she should call us at 1-800-772-1213 for assistance or she can contact her local Social Security office. Please look for the general inquiry telephone number at the Social Security Office Locator. The number may appear under Show Additional Office Information. Please be aware that our call wait times are longer than normal. We hope this information helps.
Steve U.
I am 61 yrs old. I qualified for social security disability in August 2018. When will I be eligible for Medicare coverage? Thank you.
Vonda V.
Hi Steve, thank you for using our blog to ask your question. After you receive Social Security disability benefits for 24 months, you’ll be eligible for Medicare. You will get information about Medicare several months before your coverage starts. If you have permanent kidney failure requiring regular dialysis or a transplant or you have amyotrophic lateral sclerosis (Lou Gehrig’s disease), you may qualify for Medicare almost immediately. Our brochure, “What you need to know when you get Social Security Disability benefits” provides additional details that you may find helpful.
William
My wife and I are both over 65 and have Part A. I am retired civil service and have maintained my FEHB since retirement. I was recently approved as 100% disabled by the VA on Apr 2, two days after the window closed for Part B enrollment. Although we will maintain the FEHB insurance, my wife needs to now be enrolled in Part B to obtain a Defense Dept ID card. Can she enroll now or must she wait until the next open enrollment in January? I understand there are slightly different rules when FEHB is involved, but can’t seem to find them. With all SSA offices closed, there is no one to contact until this pandemic ends. Suggestions?
Vonda V.
Hi William, thank you for using our blog. If outside of the Initial Enrollment Period, the next General Enrollment Period may be the next step. However, contact your local Social Security office for confirmation. Please look for the general inquiry telephone number at the Social Security Office Locator. The number may appear under Show Additional Office Information. Please be aware that our call wait times are longer than normal. We hope this information helps.
Barbara C.
If i have insurance thru my husbands work do I need to still get medicare? i do know i want to get Part D, but was wondering about the other.
Susan H.
My mom is 79 year old and recently signed up for Part B because my Dad retired December 31,2020.
She enrolled on January 13, 2020 and after several phone calls this week she was told she would not have benefits until July!!!! Why is it so confusing and nobody has the same answer? It depends on who you ask. She is easily confused and I’m not sure what to do for her but she told me they act very irritated with her on the phone for asking questions.
Can someone please give us a straight answer. I am willing to make an appointment and bring her to the office just so we can have our answers face to face. I get the feeling we our bothering them by the tone they have in their voice. I just want answers for her,
Robert W.
I am 67 and retired. My wife has insurance through work and will retire next month. We have filled out the Medicare Part B form for her Employer but need to know where to fax it to or send it to so I can continue with insurance.
Thank you
Ann C.
Hi, Robert. Thanks for your question. Your wife will need to complete and submit both Form CMS-L564 and Form CMS-40B to her local office. We hope this helps.
Joan W.
I am retiring May 31, 2020 at which time I will no longer have my Aetna insurance. I have Medicare Part A and am applying for VA Champa insurance which requires that i ALSO have Part B. Can I now enroll in Part B and if so, how do I do that?
Ann C.
Hi, Joan. Thanks for your question. 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.