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

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Comments

  1. Vicki

    I’m not sure I’m in the right place but here goes…My husband is on disability. He has remained on my insurance so there was no need for Part B. He will turn 65 in February 2017. I just called to see about getting Part B and signing him up for Medicare Advantage only to be told he will have to serve a penalty because I retired in 2013. I wasn’t aware that he had to come off my insurance when I retired. I thought, mistakenly evidently, that he stayed on my insurance until he turned 65. He is a diabetic. He has heart issues. He suffered a broken back in August 2016 and is still in a brace. He spent 27 days in hospital from this accident and while there was diagnosed with dementia! I am totally at the end of my rope and don’t know what to do. My insurance says he has to drop to Medicare Advantage at age 65 which won’t pay anything that Medicare won’t pay for. If he doesn’t have Part B our ship is SUNK. What can I do? There has to be a solution to this.

  2. mike w.

    i have been enrolled in part B for october 2016 and did NOT apply for it. I do not want part B at this time. how can i get removed from part B coverage???

    • J.Y.

      Hi Mike. In order to voluntarily terminate or opt out of Medicare part B, a signed request for termination and a personal interview are required. To schedule your interview, call us at 1-800-772-1213 (TTY: 1-800-325-0778) Monday through Friday from 7:00 AM to 7:00 PM, or contact your nearest Social Security office. Thanks!

  3. LWilliams

    I just started collecting benefits under ex-spouse. Not one person told me my Medicare card would change to my former spouse’s number with a B at end. When a pharmacist tried to input my Medicare card number it came back as INACTIVE – to my complete disappointment – tried calling Social Security – what a nightmare – I can’t be put on hold for hours at a time. Then just today I get a new Medicare with ex-spouse’s Medicare number – no explanation – just this is your Medicare card. I have to say this is very poor service – and left me not knowing why and thinking that somehow I was taken out of the system (a seemingly common error on Social SecurityMedicare- SHAME ON YOU!!!) As senior citizens we deserve better than something like this and full accountability and explanations – Not a surprise like this. I will be writing my legislators – Something like this should NEVER happen

  4. Gwyn D.

    Humana cancelled my supplemental Rx insurance (although they are still keeping my autopayment each month). Will I be penalized when I change to another provider during open enrollment?

    • ..

      Hello Gwyn. For questions regarding enrollment or choosing a prescription drug plan or Medicare Advantage plan with prescription drug coverage, please contact Medicare at http://www.medicare.gov or 1-800-MEDICARE. You can also obtain assistance through your State Health Insurance Assistance Program (SHIP). SHIP telephone contact information is on the back of the “Medicare & You” handbook or by going to http://www.medicare.gov/contacts/organization-search-criteria.aspx. Hope this helps.

  5. Pamela N.

    I am older than my husband and he is not on medicare yet. I have not work out side the home much so I applied an received medicare A & B under him. We could not afford part B so we had to drop it. How can I re instate part B.

    • R.F.

      Hi Pamela, based on the information you provided, and if you are not eligible for a Special Enrollment Period, you can sign up for Medicare Part B during the General Enrollment Period from January 1 to March 31 of each year. Click here to learn more about the Medicare enrollment periods. In addition, you can visit the Medicare website to learn about programs available to assist people with low income to pay for Medicare expenses. Many states also have programs to help with Medicare payments. You can find out about them by calling your State Medical Assistance Office. To get the local phone number, call the Centers for Medicare & Medicaid Services at 1-800-633-4227 (TTY, 1-877-486-2048). we hope this information helps.

  6. Val Y.

    I just need a simple answer to a simple question without having to sit on hold for 10 minutes on the phone. If my husband is supposed to get Medicare in July, is he supposed to get a card in April or May? Our postal carrier is constantly losing our mail. I have no idea if they have lost it or if it’s just not here yet. The only way we even know he’s getting coverage is because we just happened to see it on the Social Security website. We never signed up for it.

    • R.F.

      Hi Val. Individuals already receiving Social Security benefits, and becoming eligible for Medicare, will be automatically enrolled in Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). Generally, the card comes in the mail within three months before the month these individuals become entitled to Medicare benefits. Your husband should receive his card at any time now, before the month of July. Beneficiaries with a my Social Security account, can get a replacement card if their original card is lost or destroyed. Please read our publication: Medicare for more information.

  7. Enroll M.

    Hi Buddy !!..
    I just wanted to know increasing cost per year of Medicare insurance ??.

    For more info please visit :- http://goo.gl/Cofdn0

  8. Ken

    I have been collecting SSDI for 24 months and received a notice today about a reduction in my monthly award do to medicare plan B. I still have medical coverage and dont need the medicare. If I decline the medicare can you explain what will happen with my current medical coverage.

    • R.F.

      Thank you for your question Ken. Individuals are automatically enrolled in Medicare Parts A and B after they receive disability benefits for 24 months. However, because you must pay a premium for Part B coverage, you do have the option of turning it down. A beneficiary may refuse Medicare Part B, during his or her Initial Enrollment Period, if that beneficiary or the spouse, actively works and has coverage under a group health plan based on that employment, then he or she doesn’t need Medicare part B until the work activity ends or that health care coverage is dropped. However, we always suggest that individuals speak to their personnel office, health benefits advisor, or health plan representative to see what’s best for them, and to prevent any penalties or delayed enrollment in the future. To learn more about the Medicare enrollment periods visit http://www.Medicare.gov. For specific questions about your case, call 1-800-772-1213, M-F between 7 a.m. and 7 p.m. and ask a representative to assist you, or you can contact your local office directly. Hope this helps!

      • Ken

        Ray, Thanks for your response. I Have Aetna as my medical carrier under my retirement benefits do you think under my plan that if I’m offered Medicare that I would have to take it and how would my former company or Aetna know I was offered Medicare. Thanks, Ken

        • R.F.

          Everybody’s situation can be different Ken, your Aetna health-plan representative will be in a better position to answer your question. Also, the Centers for Medicare & Medicaid Services is the agency in charge of the Medicare program. You can read “How Medicare works with other insurance” or visit http://www.Medicare.gov. for more information. As a reminder, you may refuse Medicare Part B during your Initial Enrollment Period, if you are covered under a group health plan based on your or your spouse’s current employment.
          For specific questions about your case, call 1-800-772-1213, M-F between 7 a.m. and 7 p.m. and ask a representative to assist you, or you can contact your local office directly.

  9. David B.

    To stay healthy, organised and focused in your life, it is necessary that if you have any elder person in your home, you should provide assistance to them in their medication and illness. If it seems as not possible, then you should contact the professional companies for help. Bluebird Care Barnet provides homecare support to the older citizens so you can continue your life with ease. http://www.bluebirdcare.co.uk/barnet/home

  10. Enroll M.

    Nice post! it sort out my confusion about selection of plan for myself. http://ow.ly/Y78Ns

Comments are closed.