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. ht

    Does a Medicare Supplement Insurance, not a Medicare Advantage plan have an enrollment period?

    • Vonda

      Hi ht, thanks for using our blog. If you need information about Medicare Savings Programs, Medicare Advantage Plans, Medicare Prescription Drug plans or how to enroll in a plan, 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.

  2. Maria

    I’m 64 years , turning 65 on August of 2021.
    When should I apply for Medicare. Not receiving retirement benefit.

    • Vonda

      Hi Maria, thank you for using our blog. 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. We hope this helps!

  3. doris m.

    I need the email for send completed form for Medicare Part B, thanks

  4. Sylvia P.

    I need to cancel Medicare B, I denied coverage but system shows I am enrolled.
    How do I fix this?

    • Vonda

      Hi Sylvia, thanks for using our blog. Check out our Frequently Asked Questions web page for details on how to terminate Medicare Part B. If you’ve already done that, and need to check on the status, 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. Emma F.

    I will be turning 65 on July 2021 and receive social security. Am I automatically covered under Medicare on July or do I have to apply on 12/07/2020.

    • Vonda

      Hi Emma, thank you for using our blog. Generally, individuals receiving Social Security benefits are automatically enrolled in Medicare Parts A and B. Check out our Frequently Asked Questions web page for more details. We hope this helps!

  6. ROBERT L.

    I CALLED 1-800-883-2967, 4 TIMES PUT ON HOLD FOR MORE THAN AN HOUR, WHAT’S UP WITH THAT?

    • Vonda

      Hi Robert, thanks for using our blog. We are sorry to hear about your experience. 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.

  7. Ellen R.

    If I do not need to change my coverage for next year, do I need to do anything, or will all coverage, including prescription, automatically roll over?

    Thank you.

    • Vonda

      Hi Ellen, thanks for using our blog. If you find that your current coverage still meets your needs, then you don’t need to make any changes. 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.

  8. Jose A.

    My father needs to submit an original copy of his naturalization certificate for Medicare. it’s my understanding that there are no walk-ins because of COVID-19. Where can he make an appointment to submit the original to proceed with his Medicare application? Thanks!!!

    • Vonda

      Hi Jose, thanks for using our blog. Your father should contact his local Social Security office. 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. Perry B.

    I’ll be 65 this next year. Is it time for me to apply for medicare?

    • Vonda

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

  10. Carmen M.

    unable to sign into my account due to many attempts, account is now block. How do I start over OR have the restriction removed from my account? I need a replacement Medicare Insurance card to change my Insurance plan.

    Thank You

    • Vonda

      Hi Carmen, thanks for using our blog. We are sorry to hear about the difficulties you are experiencing with your my Social Security account. For assistance with your account and replacement card, you may call us at 1-800-772-1213 (TTY 1-800-325-0778) 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.

      Check out our Frequently Asked Questions web page for additional details on Medicare replacement cards.

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