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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Anita R.
How can I have Part D premium deducted from monthly SS?
Don &.
I wish to opt out of Medicare A & D enrollment for now as I am still employed and wish to use the employer’s insurance. Their insurance is credible to Medicare’s A and D and it also covers my spouse. Next year I will be retiring and will wish to enroll in Medicare at that time. I turn 65 tomorrow and haven’t been able to reach the right person to handle this in months. Time is running out, can you please help? Thank you
Ray F.
Hi Don. Our policy requires a personal interview be conducted with everyone who wants to terminate their Medicare Part A & Part B benefits. Representatives at your local Social Security office will help you submit the required Form CMS-1763, “Request for Termination of Premium Hospital and /or Supplementary Medical Insurance”, or your signed request for termination, but we need to speak to you personally before we terminate your Medicare benefits to be sure that you fully understand the consequences of doing so. We do not offer Form CMS-1763 online.
In most cases, you can only request disenrollment or changes to your Medicare Part C & D during the Annual Enrollment Periods, and would need to contact Medicare directly at 1-800-633-4227.
Also, 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.
Generally, when calling our toll free number at 1-800-772-1213, you will have a shorter wait time if you call later during the day or later in the week. We hope this helps!
Betty S.
How do I cancel part d coverage?
Ray F.
Hi Betty, please see Medicare’s web page: “How to drop your Medicare drug plan” for information on this topic. Thanks!
Jeff
I’m currently on Medicare and retired from a public service job of 30 years. recently moved to a new state and the Senior Advantage Plan (HMO) I had before isn’t in the new state. I will need to find another SAP or supplement in the new state now to coordinate it with Medicare. I am in my own open enrollment period now with the retirement system that administers my benefits and my existing Senior Advantage Plan. The open enrollment period for Medicare ended already. Will I be able to select a new SRP or supplement after the normal Medicare open enrollment period ended? I will be working with a broker in the new state to find a competitive plan soon.
Charoonsri S.
Information is helpful and complicate.
LYNN S.
i would like to add part B to my plan.i have part A how do I do this? I would like to speak to someone on the phone.
Ray F.
Hi Lynn, if you are covered under a group health plan based on your (or your spouse’s) current employment, you may qualify for a Special Enrollment Period that will let you sign up for Medicare Part B. If you didn’t sign up for Medicare Part B when you were first eligible, and you aren’t eligible for a Special Enrollment Period, you can sign up during the General Enrollment Period between January 1–March 31 each year. To learn more about the Medicare enrollment periods visit http://www.Medicare.gov. Please call our toll free number at 1-800-772-1213 for further assistance. Representatives are available Monday through Friday, between 7 a.m. and 7 p.m. We hope this information helps.
Janet M.
Need help with the enrollment
Ray F.
The Medicare Open Enrollment ends tomorrow, December 7th. Please visit http://www.medicare.gov or call them at 1-800-MEDICARE (1-800-633-4227). Thanks!
Mickey W.
November 29, 2017
Would someone … anyone please provide me with credible researchable document(s) that substantiate; why … December 7th is the ‘line drawn in the sand’ for this “Open Enrollment”? Where (i.e.: who, what, where, when AND WHY) did this originate from? Is this date and the term and meaning; is it a rule – a guideline or is this legislated law?
Ray F.
Please contact Centers for Medicare & Medicaid Services at 1-800-633-4227 (TTY 1-877-486-2048) for additional information or other questions about this matter.
Richard C.
My wife’s insurance coverage on me ends June 1, 2018. Do I need to sign up for Part B (already have part A) now or can I wait until March 2018?
Ray F.
Thanks for your question, Richard. If you are covered under a group health plan based on your wife’s current employment, you may qualify for a Special Enrollment Period (SEP) that will let you sign up for Medicare Part B. You have an 8-month SEP to sign up for Part A and/or Part B that starts at one of these times (whichever happens first):
• The month after the employment ends
• The month after group health plan insurance based on current employment ends.
Usually, you don’t pay a late enrollment penalty if you sign up during a SEP.
You should always check with your health benefits advisor, or health plan representative to see what’s best for you. To learn more about the Medicare enrollment periods visit http://www.Medicare.gov. Please call our toll free number at 1-800-772-1213 if you need further assistance. Representatives are available Monday through Friday, between 7 a.m. and 7 p.m. Thanks!
Ricki H.
why is my premiums taken out of my account when I was told they wouldn”t.
Ray F.
Hello Ricki, we apologize for this inconvenience. For security reasons, we do not have access to personal records via this blog. Please continue working with your local office. If you are unable to visit your local servicing office, you may call our toll free number at 1-800-772-1213. Representatives are available Monday through Friday, between 7 a.m. and 7 p.m. Generally, you will have a shorter wait time if you call later in the week. Thanks.