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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COLLEEN V.
Great post ! I Appreciate the analysis – Does someone know if my assistant could possibly access a sample IRS 1040 – Schedule E example to fill out ?
Medicare S.
Can i change my Medicare Plan in between of the year according to my health needs? Please guide. http://ow.ly/Y78Ns
Irma
Do you have to get medicare if you get social security benefits?
R.F.
Medicare and Social Security are two different programs. Medicare is our country’s health insurance program for people age 65 or older. If you already get Social Security retirement benefits, you can get Medicare at age 65. Also, you can receive Medicare benefits after receiving disability benefits for 24 months. If you don’t get Social Security benefits and you are not ready to apply for them yet, you can sign up for Medicare only, three months before your 65th birthday. Generally, you will be enrolled in Medicare Parts A and B automatically. However, because you must pay a premium for Part B coverage, you have the option of turning it down. For “More Medicare Information” read our publication Medicare. For specific questions about your situation, you can call 1-800-772-1213, Monday through Friday, between 7 a.m. and 7 p.m. and ask a representative to assist you. Generally, you’ll have a shorter wait time if you call later in the day or later in the week.
william g.
I never wanted to be enrolled in the SOCIALIST SECURITY SYSTEM ! If we all demand that the so called “HEALTH EDUCATION WELFARE EDUCATION SYSTEM “was closed down and we ordered that the GOV. pay the Citizens the money from those programs ,we would all have $ 70,000.oo to spend on health care, education, welfare, and that is just starters ….. it is by any definition a racket …! or people can continue to buy into DENEY ,DENEY ,appeal PAY LAWYERS for an entitlement ! If a private insurance company did what the gov does they would go to jail ….hum that might be worth thinking about ?! If you want to talk about revolution leave me out ,in this country we the people are the authority over the gov.
Richard w.
Very helpful information…thanks
R.F.
We appreciate your feedback Richard! We are glad we can help. Please continue using our online services.
Nevaeh
That’s cleared my thoughts. Thanks for cotintburing.
Kenneth K.
I will turn 66 on Dec. 19th and I am still working full time,will I be able to enroll in medicare and how do I go about it.
robin m.
My husband will be 65 on Tuesday. He is already enrolled in part A and B through SS. He wants dental and prescription…. Here is the important part; He does not want the advantage program. HE WANTS TO KEEP ORIGINAL MEDICARE and get part d and dental separate. How does he do this? I found Florida Blue offers dental for $33. per month. Any suggestions on RX?
SHIP C.
Go to the medicare plan finder to compare the prescription drug only plans in your area: https://www.medicare.gov/find-a-plan/questions/home.aspx.
Choose the “Personalized Search” for the most accurate and personalized information.
CMS also has a series of youtube videos which can explain and demonstrate how to use the tool : https://www.youtube.com/watch?v=4SCvgSZURBA
Alternatively, you can contact your state’s SHIP. I am a SHIP counselor in Alaska who randomly ran across this website and started providing answers. I am an unbiased Medicare specific insurance counselor. I am not reimbursed by insurance companies. I work for a little non-profit. Each state has a SHIP office with people just like me who are paid by the federal government to provide personalized Medicare Counseling and education. Follow the link below to select your state and find their SHIPs contact information:
https://www.medicare.gov/Contacts/#resources/ships
Lynn
I have already applied for med part A but have insurance thru my employer. Now I need to get part B because I am going to retire in Jan. How do I do this?
SHIP C.
At least in my state (Alaska) you HAVE to call social security. Some people can go online to SSA.gov. You could try that first and see if the website kicks you out. If it does, and it usually does, then you will have to visit your local ssa office or call them and request Part B under a special enrollment period. Make sure that if you are going to be eligible for any retiree health coverage that you contact your benefits administrator first to find out how your retiree coverage will work with medicare. You can also contact your local SHIP: https://www.medicare.gov/Contacts/#resources/ships
alan f.
i will be 65 next apr.29, 2016. i am currently on social security disability and have been for 2 years in jan. when will i be able to receive medicare and what do i have to do to get it?
SHIP C.
Alan,
You are eligible for Medicare after exactly 24 months of receiving SSDI checks. SSA calculates your two year waiting period based on the first month you actually received money, not the first month you were eligible. SSA will automatically sign you up. You don’t need to do anything. They will send you your Medicare card in the mail with a “Welcome packet” of information. If you don’t receive a Medicare card, that means you have a problem ( often the problem is that SSA doesn’t have the most current address for you) and you will need to call them and explain your situation. I have seen SSA send people Medicare cards as early as 6 months before their 65th birthday, or 24th month of receiving SSDI checks.
Part D.
How can I find out what my penalty will be for enrolling in Part D for the first time even though I was eligible to enroll apparently in 2006? Is there a website table I can look at? Is the fee a set amount or does it depend on income? Do I need to call someone? Thank you!
R.F.
You can learn all about Medicare Part D and the late enrollment penalty, by contacting Medicare directly at 1-800-633-4227.
SHIP C.
Hi there,
I am a SHIP counselor (State Health Insurance Assistance program) and my job is to help people navigate and understand their Medicare benefits. I am not reimbursed by insurance companies for the counseling and education I provide. I counsel folks on this stuff day in and day out. Rather than trying to do calculate the Part D premium penalty by hand, I use a special calculator hosted on the the website listed below. I honestly know nothing about who they are or what they do (insurance company I’d guess?), but their estimates are consistently correct. You can trust the numbers they provide you for your penalty.
http://www.waughagency.com/2013/11/medicare-part-d-penalty-calculator/