Medicare

Medicare Open Enrollment: Five Things You Need to Do

November 30, 2015 • By

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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. Jerri D.

    I am on medicare disability and am 65 years old. How do I get dental coverage?

    • Vonda

      Hi Jerri, thanks for using our blog. If you need information about Medicare Savings Programs, Medicare Advantage Plans, Medicare Prescription Drug plans, or the covered services, please call 1-800-MEDICARE (TTY 1-877-486-2048) or visit http://www.medicare.gov. We hope this helps.

  2. Michael H.

    I just applied for my Social Security to begin in March 2021. Do I automatically get enrolled in Medicare A and B?

    • Vonda

      Hi Michael, thank you for using our blog. Generally, individuals receiving Social Security benefits are automatically enrolled in Medicare Parts A and B when they turn 65. We hope this helps!

  3. Anna W.

    Hi there,

    While surfing the web and trying to learn more about Medicare I came across this website https://medicarepal.com I am turning 65 soon and I will become eligible for Medicare. Is it possible to get a Medicare at 64 ? Thanks in advance

  4. Nancy L.

    I need to sign up for Medicare part B I have part A already.

    • Vonda V.

      Hi Nancy, thanks for using our blog. Check out our Frequently Asked Questions web page for details on how to sign up for Medicare Part B if you already have Part A. We hope this helps!

  5. Emiko K.

    after having worked for state of Cal 25 years, not in receipt of social security, i would like to know if i now qualify for medicare. I find it to believe everyone else on medicare receives so much and i still get nothing.

    • Vonda V.

      Hi Emiko, thanks for using our blog. To inquire on Medicare eligibility, 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.

  6. James W.

    I am 81 years old. I am a veteran and always use my VA benefits. I am asking if I can cancel my Medicare, because I never use it.

    • Vonda V.

      Thank you for your service, James! Enrolling in Medicare is your choice. However, because you can only sign up for Medicare Part B during designated enrollment periods, if you choose not to enroll when first eligible and later change your mind, you may have to pay a late enrollment penalty for as long as you have Part B coverage.

      Check out the Veterans Administration web page for additional details on VA health care and how it works with Medicare and other health insurance.

  7. Joyce E.

    I want to sign up for medicare, but do not need a
    prescription plan as I have Insurance with one from work. What do I need to do?

    • Vonda V.

      Hi Joyce, thank you for using our blog. Generally, individuals receiving Social Security benefits are automatically enrolled in Medicare Parts A (hospital insurance) and B (medical insurance). If you are at least 64 years and 9 months old and aren’t receiving Social Security benefits, you can apply for Medicare A and B online.

      If you have questions related to Supplemental (Medigap) policies, Medicare Advantage Plans or Medicare Part D (Prescription Drug Plans), call 1-800-MEDICARE (TTY 1-877-486-2048) or visit http://www.medicare.gov. You also can request information about how to contact your State Health Insurance Counseling and Assistance Program (SHIP). The SHIP offers help with your Medicare questions. We hope this helps.

  8. Allean L.

    Does Medicare pay for eye exams and dental?

  9. gary a.

    How do I cancel my Plan B coverage. I have full coverage by V.A. and will never use my Plan B coverage!

    • joe w.

      How do I cancel my plan b coverage. I have full coverage with the VA and will never use my plan b coverage.

      • Vonda

        Hi Joe, thanks for using our blog. Check out our Frequently Asked Questions web page for details on how to terminate Medicare Part B.

        Enrolling in Medicare is your choice. However, because you can only sign up for Medicare Part B during designated enrollment periods, if you choose to terminate and later change your mind, you may have to pay a late enrollment penalty for as long as you have Part B coverage.

        Check out the Veterans Administration web page for additional details on VA health care and how it works with Medicare and other health insurance.

  10. Nagy B.

    How to get your medical coverage if you out of the States,?

    • Vonda V.

      Thank you for your question, Nagy. Medicare generally does not cover health services while you are outside the United States. Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa and the Northern Mariana Islands are considered part of the United States. To learn more about Medicare coverage outside of the United States, check out our publication on Payments while Outside the United States.

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