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. Ricki H.

    I was told that I would not have my premiums taken out of my check but they are taken money out of my S.S. checks so I want to check my social security and find out why they are taken money from me.

  2. edwin p.

    what medicare advantage plans are being offered in boston, massachusetts? please specify all companies involved or point me in the right direction

    thank you

    • Ray F.

      Please visit http://www.medicare.gov to find and compare plans in your area. Thanks!

  3. Rick W.

    I will be turning 65 in February 2018. I presently am working full time and get insurance through my employer. Not sure when I will be retiring. What form do I need to complete even though I am not ready to retire?

    • Ray F.

      Thank you for your question, Rick. Eligible individuals should sign up for Medicare three months before their 65th birthday, even if they’re not ready to start their monthly cash benefits. You can use our online retirement application to sign up for Medicare ONLY and apply for retirement benefits at a later date.
      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. We hope this helps!

  4. Lida P.

    I worked for 33 yrs overseas I am 78 yrs now back in the states collected SS SINCE 65yrs what do I do. Or?

  5. ramon c.

    I turned 64 in august, at what point do I apply for medicare when am I eligible?

    • Ray F.

      Thank you for your question, Ramon. Eligible individuals should sign up for Medicare three months before their 65th birthday, even if they’re not ready to start their monthly cash benefits. You can use our online retirement application to sign up for Medicare ONLY and apply for retirement benefits at a later date. Since you must pay a premium for Part B coverage, you have the option of turning it down. However, we suggest that individuals speak to their 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, and read our publication “Apply Online for Medicare – Even If You Are Not Ready to Retire“. We hope this information helps.

  6. Eileen D.

    Do I need to re-apply for part A Medicare every year? I applied for Part A last year and received my card, but was not sure if I need to apply every year.

  7. Riyaz K.

    This message throws a very powerful light on the ignorant and refresh’s the knowledgeable. Wonderful.

  8. Chris D.

    I’m attempting to get my Medicare card. It is my initial enrollment. I am currently receiving Social Security. I read that I will automatically be enrolled in Parts A & B. Is that correct? If so, when will my Medicare card be sent so that I can proceed to get additional coverage which requires a Medicare card?

    • Ray F.

      You are correct, Chris! Generally, individuals receiving Social Security benefits who become eligible for Medicare, are automatically enrolled in Medicare Parts A and B. Your Medicare card will arrive in the mail at the address on file with Social Security. Typically, you can expect to receive your Medicare card at least 6 weeks prior to the month your entitlement for Medicare begins. Please call our toll free number at 1-800-772-1213 (TTY 1-800-325-0778) to inquire about the status of your card. Representatives are available Monday through Friday, between 7 a.m. and 7 p.m. Thanks.

  9. Jose T.

    I am enrolled in part A and I did it at the time I started taking social security benefits January 1st. 2017, and I am still working and have health insurance through employer, and that is why I have not apply for part B or D, but as soon as I stop working, I will go apply for B and D, and my question is: Do I have to apply for B and D even if I don’t want to as we are living in free country? Please let me know. thanks.

    • Ray F.

      Hi Jose. 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. Because you must pay a premium for Part B coverage, you do have the option of turning it down. 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 program, please visit http://www.medicare.gov. Thanks!

  10. Belinda

    I get so tense this time of year , this should be much easier I’m 56 and this is so difficult for me to figure out you send out a book with 50 different companies to choose from .I feel sorry for anyone having to deal with this if we all just had the same drug cost and copay sure would make life easier , its so hard to know who to pick, I can only imagine when the older people have to do this how stressful they must feel , this has got to be easier any help greatly appreciated thank you

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