Medicare

Medicare Open Enrollment: Five Things You Need to Do

November 30, 2015 • By

Reading Time: 3 Minutes

Last Updated: November 30, 2015

medicare 50th anniversary 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.

  1. 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.
  1. 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.
  1. 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.
  1. 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.

  1. 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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About 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

  1. Randall S.

    I have tried to do a My Social Security account 3 times in the last 3 days. Now am locked out? My name is Randall Scott Wilson I will be 65 August 24 of 2020! (08/24/1955) I am not going to retire then. Won’t be retireing yet. But was told I must sign up 3months prior to my 65 Birthday! HELP. Randall Scott Wilson 314-379-1908. Thank You. Please HELP

    • V.V.

      Hi Randall, thank you for using our blog. We apologize for the difficulties you are experiencing with creating a my Social Security account. Even though you are unable to create a my Social Security account, you may still file for Medicare Only online.

      If you continue to have difficulties and are unable to apply online, 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.

  2. connie h.

    I will be receiving social security at 62. Will I automatically be enrolled in Medicare part A – AND part B or do I need to sign up. I may not want part B, as I have health insurance thru my retirement pension and it’s inexpensive.

    • V.V.

      Hi Connie, thanks for using our blog. Check out our Frequently Asked Questions web page for details on signing up for Medicare. Because you must pay a premium for Part B coverage, you can turn it down. However, if you decide to sign up for Part B later, your coverage can be delayed and you may have to pay a late enrollment penalty for as long as you have Part B coverage. You may find our Medicare web page helpful as well.

  3. Brenda M.

    I will be officially retired as of June 1, 2020 and need to enroll in Medicare Part B. I already have Park A.

    • V.V.

      Hi Brenda, thanks for using our blog. If you are already enrolled in Medicare Part A and you would like to enroll in Part B, you cannot use our online application. Please complete form, CMS-40B, Application for Enrollment in Medicare – Part B (Medical Insurance). If you are applying for Medicare Part B due to a loss of employment or group health coverage, you will also need to complete form CMS-L564 (Request for Employment Information). Please check out the Social Security and Coronavirus web page under “Can I enroll in Medicare?” for the forms and specific instructions on submitting the forms while the offices are closed to the public. We hope this helps!

  4. Daniel C.

    I need to get enrolled in Medicare as I will turning 65 in August 2020. Can you help with this so I don’t get penalized?

    • V.V.

      Hi Daniel, thanks for using our blog. If you already get Social Security benefits, we’ll automatically enroll you in Medicare Hospital Insurance (Part A) and Medical Insurance (Part B). We’ll mail you all the information you need a few months before you become eligible.

      If you don’t get Social Security benefits and are not ready to apply for them yet, you should sign up for Medicare three months before your 65th birthday.
      The easiest way to apply for Medicare is by using our online application.

      If you don’t wish to apply online, you can make an appointment by calling us at 1-800-772-1213 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.

  5. Elizabeth R.

    I want to drop part B. I am still working full time and have medical coverage

    • V.V.

      Hi Elizabeth, thank you for using our blog. Check out our Frequently Asked Questions web page for details on how to terminate Medicare Part B. We hope this helps.

  6. marsha a.

    I have been trying to get a Plan A card and u send me a SS card. then I have done the on line account and it wont let me in.. I call and I never get anyone and sit on the phone for an hour. I want my card for PLAN A!

    • V.V.

      Hi Marsha, thank you for using our blog. Check out our Frequently Asked Questions web page for details on how to obtain a replacement Medicare card. We hope this helps.

  7. CAROLINE N.

    HI iI AM CURRENTLY APPLYING FOR MEDICARE .. MY HUSBAND HOLDS THE HEALTH INSURANCE THROUGH HIS JOB.. QUESTION.. MY HUSBAAND IS ON DISABILITY AND HOLDS THE HEALTH. HOW DO I ANSWER THE QUESTION ON THE APPLICATION STATES ..STARTING AND ENDING DATE OF EMPLOYMENT . HIS STARTING DATE WAS OCT 1980 BUT WAS DISABLED IN FEB 2004.. IS THAT HIS ENDING DATE??

    • V.V.

      Hi Caroline, thank you for using our blog to ask your question. To ensure you are eligible for a special enrollment period, and to complete the form correctly, please 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.

  8. Richard J.

    i tried to enroll for medicare. my application was denied. says info i entered is incorrect….. who can i call or can i retry entering my info

    • V.V.

      Hi Richard, thank you for using our blog to ask your question. We are sorry to hear about the difficulties you are experiencing with the online Medicare application. Please 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.

  9. Romarica D.

    Hi I am Romarica Derodar willing to be enrolled for Medicare…I am 66 years old and really need to have medicare. I am currently living in Somerville NJ 08876. Please help me to be enrolled

    • V.V.

      Hi Romarica, thank you for your question. Check out our Frequently Asked Questions related to Medicare such as what it is, who is eligible and how to apply. We hope this helps.

  10. Denise t.

    Hi my name is Denise Hardy. I’m 54yrs old and retired/disabled. I have medicare (part A) since 2007 along w/ Blue Shield through My husbands job.He is retiring June 30. Its too expensive through his job so I am opting to enroll in medicare part B,C or D. Who can I talk to regarding which plan/plans are best for me & help me enroll? I spoke to medicare months age & they said that I did not have to wait for open enrollment. Also, that I had to go through SSA. 415 756 2072

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