AGING SERVICES: Medicare Open Enrollment

Medicare Open Enrollment: 5 Things You Need to Do

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, Open Enrollment runs October 15 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 something that’s 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 make changes to your plan.

Here are five important 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? Is your new medication covered by your current plan? 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. The State of CT Department of Social Services administers a program called the Medicare Savings Program (MSP) that provides help to many Medicare beneficiaries.  If eligible, it will pay for your Medicare Part B premium and automatically enroll you into a federal program, the Low Income Subsidy (also known as Extra Help).  This federal program pays the full premium of a standard Medicare Part D prescription plan or a portion of a non-standard plan; it lowers your prescription costs of medications on your plan’s formulary to no more than $$7.40 in 2016 and offers you a special enrollment period throughout the year to make changes in your Medicare coverage.  One level of the program, the Qualified Medicare Beneficiary Program (QMB for short), also acts in a similar fashion to a Medigap policy.  If you are eligible for this program, you would not be responsible for your deductibles or cost sharing for your Medicare Part A and B medical benefits and the State of CT could purchase Medicare Part A and B benefits for you if you do not have enough work credits to receive Medicare premium free.  Applying is simple.  Complete a three page application with no supporting documentation and mail to the Department of Social Service scanning center in Manchester, CT.  You are eligible for one of three MSP programs if you are single and your income is below $2,413.26/month or if you are a couple receiving $3,266.88/month.  The State does not consider your assets for eligibility, so your house and money in your savings and checking account will not count against you for assistance.  If you receive help from the MSP, the State of CT will not attempt to recover money from your estate after you die.  Read the MSP brochure and get the application or contact CHOICES for assistance at 1-800-994-9422.

4. Shop for plans that meet your needs and fit your budget. Starting in October, you can use Medicare’s plan finder tool at to see what other plans are offered in your area. A new plan may:
a. Cost less
b. Cover your drugs
c. Let you go to the providers you want, like your doctor or pharmacy

If you do not use the computer or would like personalized assistance from a trained, objective counselor, contact CHOICES at 1-800-994-9422 or attend one of our scheduled enrollment events.  If you find that your current coverage still meets your needs, then you’re done. 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 has been updated with the 2016 Star Ratings for Medicare health and prescription drug plans. Plans are given an overall quality rating on a 1 to 5 star scale, with 1 star representing poor performance and 5 stars representing excellent performance. Use the Star Ratings to compare the quality of health and drug plans being offered.

These are a few easy ways to get a jump start on your Medicare Open Enrollment. For more information you can call CHOICES 1-800-994-9422.  CHOICES certified counselors provide free, one-on-one, non-biased Medicare assistance and can provide you with free personalized health insurance counseling or you can attend one of our enrollment events scheduled throughout CT. 

Beneficiaries can also call 1-800-MEDICARE (1-800-633-4227) which 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 speak.

Content Last Modified on 11/13/2015 11:55:39 AM