What to Do After Open Enrollment: Next Steps for Your Health Coverage
Attention: it’s that time of year again!
The Medicare Open Enrollment period runs from October 15th to December 7th each year. During this time, Medicare beneficiaries have the opportunity to review and make changes to their plans. Those with a Medicare Advantage plan have a similar open enrollment period that runs from January 1st to March 31st.
Between 2008 and 2020, an average of 10 to 13% of Medicare beneficiaries changed their plan during the Open Enrollment period each year. Even if you don’t switch Medicare plans, this is still an excellent time to review your current coverage and take advantage of benefits.
At Senior Insurance Agency, we help clients over the age of 65 navigate the Medicare system. From plan selection to renewal and everything in between, our team is here to answer your questions.
Here’s a look at what to do after Open Enrollment to get the most out of your Medicare coverage.
Table of Content
1. Step 1: Review Your Plan and Coverage
2. Step 2: Schedule Necessary Appointments and Screenings
3. Step 3: Update Your Provider Information
4. Step 4: Organize Your Health Documents
5. Step 5: Understand Your Prescription Coverage
6. Step 6: Keep an Eye Out for Your First Billing Statement
7. Step 7: Learn How to Use Your Plan Benefit
8. Step 8: Stay Informed About Special Enrollment Periods
9. Get Health Insurance Support Through Senior Insurance Agency
Step 1: Review Your Plan and Coverage
Whether you’ve switched plans or are sticking with a plan you’ve had previously, start by confirming your enrollment. You will receive a notification by mail or be able to check the status of your plan online.
Next, take the time to review your plan’s details. Focus on benefits, services covered, provider networks, and out-of-pocket costs. If you’ve switched plans, look for any changes in coverage from your previous plan.
Optimize Your Benefits After Enrollment!
Step 2: Schedule Necessary Appointments and Screenings
Now that you’ve confirmed your enrollment, this is an ideal time to schedule any necessary medical care. Start by scheduling your annual wellness visit with your primary care provider, which is covered under Original Medicare and all Medicare Advantage plans.
If you have a Medicare Advantage prescription drug plan, you may also want to schedule a health risk assessment. This helps your healthcare provider and insurer determine how to best manage your care.
Depending on your current health status, you may also need to schedule specialist visits and other preventative screenings.
Step 3: Update Your Provider Information
If you change plans during the Medicare Open Enrollment period, be sure to get in touch with your doctors and pharmacies right away. This can help both parties avoid confusion and billing issues in the future.
You’ll also need to confirm that your preferred pharmacies and healthcare providers accept your new plan. Typically, Senior Insurance Agency will provide this information for you with your new enrollment.
Step 4: Organize Your Health Documents
Keeping your medical documents organized can make it easier to find the information you need when setting up appointments or filing insurance claims. Create a dedicated folder with your new insurance card, plan documents, and any other medical documents detailing your health status. This can be a physical folder or a secure digital folder on your computer.
Make sure your trusted family members and/or caregivers have access to your updated health information. This ensures that they can help you get the care you need in the event of a medical emergency.
Step 5: Understand Your Prescription Coverage
Prescription drug coverage is a very important component of your health insurance. Most Medicare beneficiaries have some form of prescription drug coverage through a stand-alone Part D plan or through a Medicare Advantage plan with built-in drug coverage.
After Open Enrollment, it is important to start making any changes needed for your new RX plan. You might need to transition to a new in-network pharmacy, or start working with your provider on any prior authorization requirements. Additionally, check your deductible amount, especially if you rely on high-cost medications as part of your regimen. If necessary, make a plan to pay your deductible and avoid sticker shock when you fill your first prescription.
Ensure Complete Coverage After Enrollment!
Step 6: Keep an Eye Out for Your First Billing Statement
You’ll receive the first billing statement for your plan shortly after enrollment. When you receive this first statement, check to make sure the premium amount is correct and check for any errors. In some cases you might opt for auto-pay or deduction from your Social Security check. In this case, it is important to verify the premium is being withdrawn to avoid any late payments.
If there are any mistakes on your first billing statement, get in touch with your insurer right away to correct the problem.
Step 7: Learn How to Use Your Plan Benefit
Next, familiarize yourself with your plan’s benefits so you can make the most of them. In particular, many Medicare Advantage plans offer a number of add-ons such as gym memberships, Over-the-Counter benefits, wellness programs, and telehealth services. Additionally, 94% of Medicare Advantage plans offer some dental benefits.
Read through the details of your plan and learn how to take advantage of these benefits. If you have questions about your benefits or are unsure how to use them, you can call your insurance company directly for clarification. If you have an insurance broker, you can also call them for additional support. Remember, those added on benefits are only as useful as you make them. Don’t forget to take advantage of these rich benefits offered to you throughout the year.
Step 8: Stay Informed About Special Enrollment Periods
There are some life events that may qualify you for a special enrollment period, which allows you to switch plans outside of the Medicare Annual Enrollment Period. This includes life events like moving to another state, a change in income, or losing another form of health insurance.Staying informed about special enrollment periods can help you avoid gaps in coverage if these life events occur. Keep your medical and insurance documents organized so you have the information you need readily available in the event you need to switch plans.
Learn Next Steps for Health Coverage!
Get Health Insurance Support Through Senior Insurance Agency
Taking these steps after Medicare Open Enrollment 2025 will help you make the most of your new healthcare coverage. It can also help you avoid confusion when it comes to covered services and billing.
At Senior Insurance Agency, we help our clients navigate Medicare in Carson City and throughout Nevada. This isn’t limited to the enrollment process; we’re also here to answer your questions and provide support once your plan goes into effect. Get in touch today for personalized assistance with all your insurance needs.