Learning about Medicare options is confusing enough when someone turns 65. It can be even more trying for caregivers who have to pick up the pieces where their parents left off.
Having helped dozens of caregivers with their parents Medicare over the years, I can relate to how frustrating the initial learning process truly is. I’ve put together my best tips let for assisting your parents with their coverage.
Get Listed So You Can Help on a Regular Basis
You will sometimes need to speak with Medicare on behalf of your parents. Download an Authorization to Disclose and mail it into Medicare on the instructions provided.
Check Records for An Agent
Review any records your parents have from when they set up their coverage. If you find contact information for a Medicare insurance agent, contact the agent. An agent could help you move more quickly through the steps below as they will already know a lot of this information.
Determine What Coverage is in Place
Original Medicare has two parts: Part A hospital benefits and Part B outpatient benefits. However, Medicare doesn’t cover everything. Each beneficiary will have cost-sharing at the time of service, such as deductibles and copays.
Beneficiaries can choose to stay with Original Medicare and add on a Medicare supplement and drug plan, or they can choose a Medicare Advantage plan.
Go to Medicare’s Check Enrollment Tool to determine which type of coverage your parents have in place now, or call 1-800-MEDICARE to have a representative look up their coverage.
Understand the Two Options
Medicare supplements generally have higher premiums but more predictable spending on the back end. If they have this coverage, your parents can see any Medicare provider in the nation with no referrals necessary. These plans do not include drug coverage, so most likely they also have a standalone Part D drug policy that helps them with their medications.
Medicare Advantage plans are private insurance policies which pay instead of Medicare. These are usually an HMO or PPO style plan and usually they have a Part D drug plan built-in. These plans generally have lower premiums and instead the members pay copays for services as they go along.
To learn more about how these policies differ, read this post for additional information.
First, Do No Harm
Medigap plans often have the least hassle because they cover much or all the back-end spending. If your parent has this coverage in place, it’s generally not advisable to change it while they are receiving caregiving. The policy is very likely paying a great deal toward their medical care.
Because these plans require underwriting, if they were to leave the plan, it would be unlikely they could pass the underwriting in the future to qualify again in most states. Keeping the current policy may be the best bet. However, you can help control costs by shopping their drug plan every year.
Since Medicare Advantage plans have networks, you should check with your parents providers before changing plans so that they don’t lose access to an important doctor. Once they change they are locked in for the next calendar year unless a special circumstance occurs.
Review the Annual Notice of Change
Every year, Part D plans and Medicare Advantage plans send out an Annual Notice of Change in September. This tells you exactly what benefits are changing next year. Carefully review this document to see if there are any problematic changes. For example, if the plan is dropping one of your parent’s important medications, this might be a reason to change.
Use the Medicare Plan Finder Tool
Make a list of their current medications. Enter the list into Medicare’s Plan Finder Tool to compare all the plans in the state and find the one that offers the lowest costs on medications. If their current plan is still the best, nothing else is needed. It will automatically renew.
Apply During the Election Period
If a different plan offers savings, you can help your parent apply for that plan between October 15th – December 7th. The new coverage will begin January 1st.
It’s easy to change drug plans through an agent or by calling Medicare.
Organize their ID Cards
Members must present their ID cards at the time of service. This will be either a Medicare card, a supplement card and a Part D card OR a Medicare Advantage plan card. Make files for each coverage and include a copy of the ID card in each file in case one gets lost.
Notify Providers of the New Coverage
Be sure to give doctors and pharmacies copies of the new coverage so that there are no billing errors in the new year.
Danielle Kunkle Roberts and her team help baby boomers and seniors with their Medicare decisions. Learn more at https://boomerbenefits.com.