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. JoNell C.

    Is it correct that I cannot drop my Part B Medicare Coverage except during the open enrollment period? I just realized that due to the fact I covered under my husbands insurance at work I do not need Part B.

    • Ray F.

      Thank you for your question, JoNell. In most cases, you can only request disenrollment or changes to your Medicare Part C & D during the Annual Enrollment Periods.
      If you are talking about your Medicare Part B, our policy requires a personal interview be conducted with everyone who wants to terminate their Medicare 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.
      To make an appointment with your local Social Security office, call our toll free number at 1-800-772-1213. Representatives are available Monday through Friday, between 7 a.m. and 7 p.m. Thanks.

  2. PATRICIA A.

    DO I HAVE TO APPLY FOR MEDICARE IF IF MY EMPLOYER PROVIDES MY HEALTH INSURANCE?

    • Ray F.

      Hello Patricia. Generally, when you apply for Medicare, you can sign up for Part A (Hospital Insurance) and Part B (Medical Insurance). However, because you must pay a premium for Part B coverage, you can turn 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. To learn more about the Medicare enrollment periods visit http://www.Medicare.gov. Hope this helps!

  3. Minnette M.

    I am searching for a Credible Coverage form, where can I find that to print?

  4. Ronnie M.

    I’m covered on my wife’s Insurrance where she works, will I still be put on Medicare part B?

  5. Leslie G.

    I made a comment and it didn’t post – the required information was there! My husband and I stayed with an insurance company thinking it would be the same – it worked for us. After the change date was past we found out we could no longer afford my husband’s meds (they changed the tier or something) so I am no longer taking my meds (non-life threatening) so that he can have his. We have a co-pay we can’t afford for mine/and his. We tried having the doctor change his script for the cheapest possible and the insurance company said they would not cover it. Sounds like kickbacks to me. I am so upset – don’t know if new policies are coming so that we can change companies at will. Insurance companies are running healthcare and the “care” in healthcare is totally GONE!

  6. Leslie G.

    We stayed with a plan because it worked for us. After staying, the plan changed and we cannot afford our medication – mostly my husband. I am no longer taking my medication (because it is not life threatening) so that he can take his (life threatening – heart/diabetes)

  7. Nick M.

    Wouldn’t it be nice if CMS sent people a short note letting them know if they are even eligible for Medicare? I am eligible for Social Security, but don’t have a clue if I am also eligible for Medicare part A and B. If I knew this in advance, it would help me decide what to do. If I have to pay for A and B, how much is it, and if I get Social Security, will those payments pay for the Medicare premiums?

  8. Sandra K.

    I have been out of the country for a year and a half..How do I re-enroll my Medicare? Thanks, Sandy

    • Ray F.

      Hi Sandra, if you didn’t sign up for Medicare 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. For more information call us at 1-800-772-1213, Monday through Friday, between 7 a.m. and 7 p.m. and ask a representative to assist you, or contact your local Social Security office. Thanks!

  9. Elizabeth R.

    On October 1st 2017, I will sent a letter indicating that I would get Medicare benefits starting January 1st 2018. I have been fighting for my Medicare card to arrive for the past 2 months. I was told that my enrollment is not until May of 2018. I have the proof of the letter you all sent me regarding my approval for benefits starting January 1st. I am in dire need of help. I am disabled and have been given the runaround for too long. Please help.

  10. Michael D.

    How can I find out information about paying the 20% for medicare insurance?

    • Michael D.

      What plans are there?

Comments are closed.