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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Deacon D.
Why are so many people confused about the essentials of Obama Care? Shouldn’t there be closer workings with the overall Faith Community. And a clear revelation of the relationship between the Departments of Education and HHS in terms of what
can be done for poor stay-at-home parents who are in recovery rehabilitation?
Velvet
Thanks for sharing. Your post is a useful coinbirutton.
Glenn W.
Good morning. I am posting this on behalf of my husband who is receiving SSI disability benefits. The medicare Part B was declined because he is covered under my employer paid health insurance. We did what the letter said to decline Part B. He received a letter yesterday 12/2/15 stating that his benefits for December 2015 will begin in January 2016 with an amount being deducted that is the taxes withdrawn from his benefits monthly. So if the letter is correct he will not receive any benefits for the month of December? Can you explain this?
janet F.
Hello, I am 60 yrs. old, I have been on disability since 2010. Do I have to contact SS to keep taking my premiums out of my check ea month if I change carriers. Why cant middle class people get assistance for medical if they are between husbands making to much to get extra help. when the husband cant help the spouse because he has his own medical to pay because he is not disabled. please help me
R.F.
Hi Janet, if you receive Social Security benefits, we will automatically deduct the Medicare Part B premium from your monthly payments. For information about changes in your medical coverage contact Medicare directly at 1-800-633-4227.
Daniel
Doctors sign contracts with most MA plans. You sholud ask, Are my doctors in the network? And you might ask your doctor’s business manager/contract manager if the MA pan pays its bills on time.
Dale R.
Does the open enrollment deadline for changing the Part B primary care doctor apply to those who are on SSDI disability?
R.F.
Hi Dale. Please contact Medicare directly at 1-800-633-4227 to discuss changes on your medical coverage.
Brenda F.
Please send new Medicare Card,please!!
R.F.
Good news Brenda! Now you can get a replacement Medicare card or immediate proof that you have Medicare by using your online my Social Security account. Hope this information helps!
M S.
I will turn 65 on May 17, 2016. I have been receiving information for companies for “Medicare Supplement coverage”.
The information says “you have this One Enrollment Open Enrollment period in you life.” Medicare Supplement coverage of your choice without medical questions. Enrollment period expires December 07,2015. My question is, do I need to sign up for supplement insurance now or do I wait until I turn 65.
R.F.
Please contact Medicare directly at 1-800-633-4227 to discuss your question.
Yolanda M.
I just turn 65 in nov 2 2015..I only enrolled for part A medicare because I have Medical thru California County. I didn’t enroll for part B because I can’t afford 104.90 deduction out of my retirement benefit. Please advice thank you
R.F.
Hi Yolanda! You may qualify for Supplemental Security Income (SSI) payments. SSI is a needs based program that gives cash assistance to people with limited income and resources, who are age 65 or older, blind or disabled.. Please call us at 1-800-772-1213, Monday through Friday, between 7 a.m. to 7 p.m. for more information. Also, you may be eligible to receive social services from the state in which you live. Medicare enrollees who have limited income and resources may get help paying for their premiums and out-of-pocket medical expenses from Medicaid. Please call the Centers for Medicare & Medicaid Services at 1-800-633-4227 for more information.
Andrew (.
Thank you for a very insightful and easy to understand post about important issues. I am looking forward to your next posts. Regards, Andrew
R.F.
Thank you Andrew! for taking the time and communicating with us through our blog, we are glad you like it and appreciate your comments and feedback. Please continue using our online services and remember that even if you are not eligible for Social Security benefits at this time, you can create a my Social Security account to review your earnings record, and check for future benefits.
Ms. M.
I’m a retired federal civil servant. This is my first year with Medicare and it has been a major disappointment due to the fact that I’m in the Mayo Health care system where Mayo Clinic primary care doctors have opted out. I had excellent federal health insurance before I retired. Now that it’s secondary to Medicare it’s nearly worthless, even though I still paying the full cost for my premiums. Question 1, can I opt out of medicare and have my federal insurer become my primary again or am I forced to be in medicare? Question 2, can I opt out of Medicare part B and have my federal insurer become my primary insurer again? Question 3, If I opt out of medicare do I lose my modest “just enough to cover my medicare premium” social security benefits?
R.F.
Hello Ms. Miller, please contact Medicare directly at 1-800-633-4227 to discuss your questions.
maria d.
por favor necesito su ayuda, soy ciudadana americana, vivíamos en seattle wa. por mi enfermedad tuvimos a que dejar estados unidos por el clima y regresamos a méxico por el clima, tengo fibrosis pulmonar y hipertensión pulmonar severa, recibo pensión por discapacidad, mi enfermedad ha empeorado, y dependo de medicinas muy caras, yo estoy en el plan A desde julio 2009, necesito el plan B y C como le puedo hacer para darme de alta y también poderme inscribir con Ustedes antes del 7 de diciembre.
tenemos pensado irnos a estados unidos mcallen en mayo porque esta a nivel del mar, ya que el doctor me dice que voy a tener mejor calidad de vida porque este año he empeorado notablemente.
muchas gracias de antemano
a los estados unidos,