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Medicare Open Enrollment: Five Things You Need to Do

Medicare chief medical officer offers advice - deadline Dec. 7

By Dr. Patrick Conway, CMS Principal Deputy Administrator and Chief Medical Officer

For Medicare information about Open Enrollment, click

Nov. 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.

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.

2.    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.

3.    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.

4.    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.

5.    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. Posted on November 30, 2015.

  For more information and public comments on this post.

Medicare Annual Election Period Opens Oct. 15Related Medicare & Medicaid News - Senior Journal Archives

Senior citizens may pay much more for drugs if they don’t switch Medicare plan

Staying with same plan could mean giant price jump in drugs you have been taking – but most seniors just renew during open enrollment - By Michelle Andrews - Kaiser Health News, Oct. 20, 2015

Medicare pushing hard for Medicare Advantage, Drug Plans as Open Enrollment begins

This fact sheet may be helpful to seniors considering new options in Medicare for 2016 - Oct. 13, 2015

AARP encourages seniors to compare drug plans to save money

Medicare Open Enrollment Opens This Week, October 15 - December 7; AARP has assistance online - Oct. 12, 2015

Medicare news for seniors all good as open enrollment period nears

CMS now calling this annual period for changing plans the ‘Annual Election Period’ - Sept. 22, 2015

Medicare drug program premiums expected to stay about the same in 2016

Rates threatened by high cost of specialty drugs; growth in per-enrollee spending continues to be historically low - Aug. 19, 2015

Medicare Advantage Plans to test more flexibility for seniors with chronic ills

Medicare Advantage Value-Based Insurance Design Model targets better cafe at less cost - Sept. 2, 2015

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