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Caring for aging parents comes with plenty of challenges on its own. The last thing you want to worry about is your parents’ health insurance needs. Finding the right plan, though, isn’t always as simple as it sounds. Whether your parents are facing medical complications, transitioning to a nursing home, or simply needing help navigating technology to enroll, there are several factors you should consider before they stick with basic Medicare.

Understanding Original Medicare vs Medicare Advantage

Medicare Parts A and B, also known as Original Medicare, offer hospital coverage and outpatient coverage respectively. You can learn more about what Part A and Part B cover exactly by reading this article.

With Original Medicare, you pay for services as you get them. While Medicare will cover a lot of costs, you could still be responsible for deductibles, copayments, and coinsurance. On its own, Original Medicare will not cover supplemental healthcare (such as hearing, vision, or dental care) or prescription drugs.

Medicare Part C, or Medicare Advantage, is an alternative to Original Medicare. This plan bundles your Medicare coverage, including Parts A and B and usually Part D prescription drug coverage. Medicare Advantage can also cover things that Original Medicare does not, like vision, dental, and hearing insurance.

While Medicare Advantage has several benefits over Original Medicare, there are also a few other considerations that need to be made before choosing one Medicare option over another. If your parent has specific doctors or medical needs, you will need to check to make sure those healthcare providers are in-network and whether or not they will need a referral to see certain specialists.

If a Medicare Advantage plan covers all of your parents’ providers and services, however, then it can be a great option for anyone looking for a “one-stop shop” option for their health insurance needs.

Factoring in Medicare Part D

Medicare Part D provides coverage for prescription drug costs. This plan is offered by private insurance carriers and is available for purchase as a separate stand alone plan for those with Original Medicare or can also be included as part of a Medicare Advantage plan.

Policies vary by cost and which medications they cover, but even the least expensive prescription drug plans cover most of the generic and brand name drugs generally needed by people on Medicare. 

Even if your parents are not currently taking any expensive medications, it is still wise to be enrolled in at least an inexpensive drug plan as there are high financial penalties for adding it later.

Don’t Forget About Medicare Supplement Plans

A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs that Original Medicare does not cover. This may include copayments, coinsurance, and deductibles. 

Not everything falls under Medigap, however. A supplement plan may not cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.

With a supplement plan, healthcare costs will first be covered by Original Medicare and any leftover may be covered by the Medigap plan. 

Making the Best Decision for Your Parents

Finding the right Medicare plan for your parents begins by reviewing their situation and estimating their future healthcare needs. 

Trusting a professional is another way to make sure you find the best options for their needs. By consulting a Medicare advisor, you get:

Want to make sure your parents have the best Medicare coverage for their healthcare needs? Our local advisors have decades of experience supporting Medicare beneficiaries in finding the right coverage.

As caregivers, we become resources for our loved one in so many ways. Often, as our loved ones age, their healthcare becomes more complicated and staying on top of their Medicare coverage becomes crucial. Caregivers are a lifeline to help beneficiaries navigate their Medicare enrollment and benefits each year. 

If you're wondering where to start or how to help a parent or loved one enroll in Medicare, know that you’re not alone! We help caregivers support their loved ones daily. One of the most common questions we receive is “Can caregivers legally help a loved one enroll in Medicare?”

The short answer is, “Yes!” But it’s important to know the specifics. 

An Authorization to Disclose Personal Health Information form must be completed

Helping a loved one sign-up for Medicare involves their protected health information. So, you'll need to make sure that you are authorized to speak on their behalf about their healthcare. They will need to complete an Authorization to Disclose Personal Health Information form to give you the authority to discuss their healthcare with other individuals.

The document is an essential first step to being able to coordinate your loved one's Medicare needs. Without this form, a Medicare representative will be unable to speak directly with you regarding your loved one's plan and benefit options. 

Once You’re Authorized, You Need to Do Your Homework

Having open lines of communication helps to ensure that your loved one gets the Medicare coverage that best suits their needs. As their caregiver, you will need to talk with them to understand what their health needs are. Knowing what they are hoping to get out of their Medicare plan can help direct your focus to the aspects that will best aid them. 

It’s important to know the following about their healthcare needs:

Preparing to Meet with a Medicare Advisor on Your Loved One’s Behalf

When it's time to speak to a Medicare agent regarding your loved one's benefits, make sure that you have all the pertinent information at hand. You will be asked to provide specific personal, financial, and medical information on the individual's behalf. 

To ensure that this process goes smoothly, work hand-in-hand with your loved one and their medical providers to ensure that you have the big picture of their current healthcare. 

Work with a Knowledgeable Advisor

There's a lot of information out there about Medicare. Gain peace of mind by working with a Medicare Advisor. Licensed, local agents understand the ins and outs of Medicare and streamline your efforts to get your loved one the most appropriate plan. 

Are you helping a loved one navigate Medicare? Our experienced advisors are here to walk alongside you on this journey. Schedule a complimentary call with one of our Medicare advisors.

As our parents age, we often take on more responsibilities to help care for their needs. In this stage of life there can be both great joys as well as new challenges.

Taking care of aging parents introduces us to all sorts of new encounters – and one of those is learning how Medicare works. 

Medicare can be confusing. With all of the information available on the topic, you might find yourself unsure of where to start. The following 5 tips for helping your parents with their Medicare benefits will help you navigate through the confusion.

#1  Brush up on the Basics of Medicare

To be a resource for your parents as they enroll in Medicare coverage, first you need to know the basics of how Medicare works. We’ll start by answering “What are the different parts of Medicare?”

Medicare Part A

Medicare A acts as hospital insurance and covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. When you help your parents sign up for Medicare they will automatically be enrolled in Part A. 

Most people qualify for Part A premium-free. If one of your parents paid Medicare taxes while working, then they don’t have to pay a monthly premium for Part A (this is the most common scenario). 

Hospital expenses aren’t completely free, though, with Part A Medicare insurance. 

Medicare charges a deductible each time a beneficiary is admitted to the hospital. The deductible cost changes every year. In 2021 the deductible was $1,484. If this cost is a concern, consider looking into a Medicare Supplement plan.

Medicare Part B

Medicare B acts as general medical insurance and covers certain doctors' services, outpatient care, and preventative services. Preventative services covered by Medicare Part B include annual wellness visits, diabetes screenings, flu shots, and many other screenings and tests.

Unlike Medicare Part A, Part B comes at a cost. 

The monthly premium for Medicare Part B changes each year. In 2021 the premium started at $148.50 and increased for people with higher incomes. Additionally, there is an annual deductible and beneficiaries pay a percentage of the bills for doctor visits and other outpatient services.

Technically, your parent does not have to sign up for Part B. But, if they’re not covered by other qualifying insurance and do not sign-up for Part B when they first enroll in Medicare, then they will incur a costly penalty for as long as they’re in the program.

Medicare Part D

Wait… is there a Medicare Part C? We’ll come back to that in a moment. First, it’s important to know that Medicare Part D covers prescription drugs and is purchased in addition to Medicare Parts A & B.

Medicare Part D plans are offered by private insurance companies approved by Medicare. Every Medicare Part D plan is different, including which prescriptions are covered, which pharmacies are in-network, and what the out of pocket costs are for prescriptions. 

If you want to take a deep-dive into prescription drug coverage, we recommend taking a look at this article about the details of Medicare Part D.

Medicare Part C (Also Known as Medicare Advantage)

Parts A, B, and D of Medicare can be combined through Medicare Advantage Plans (aka Part C).

Medicare Advantage plans are offered by private insurers approved by Medicare. These plans are great because they bundle all of the coverage under a single plan. They also often include additional coverage not offered by Original Medicare such as dental and vision.

What do Medicare Advantage plans cost?

Beneficiaries enrolled in Medicare Advantage pay both a premium for their Part C plan as well as the standard Part B premium. 

While paying two monthly premiums may seem costly, often beneficiaries save on their overall healthcare expenses. Some Medicare Advantage plans even have a $0 premium or may help pay for Part B premiums.

Another Important Basic to Note

It's important to note that your parents must enroll in Medicare benefits during their Initial Enrollment Period (IEP). 

The IEP is the seven-month window around their 65th birthday (three months before and the three months after their birth month). If they miss their window, they could face gaps in health insurance coverage, incur late enrollment penalties, and have to wait for another enrollment period such as the Annual or General Enrollment Periods, which at specific times of the year.

#2 Complete an Authorization to Disclose Personal Health Information Form

Like other personal health information, there are regulations around what can and cannot be shared with someone other than the patient unless authorized. 

If your parent would like you to speak to Medicare on their behalf, they will need to complete an Authorization to Disclose Personal Health Information form

Without this form, a Medicare representative will be unable to speak directly with you regarding your parent's program options. 

For complete information, visit the Centers for Medicare and Medicaid Services website.

#3 Know Your Parents' Specific Health Needs

Oftentimes, the best Medicare plan for your parents will be based on their healthcare needs.

Talk with your parents to understand what their health needs are. Knowing what they are hoping to get out of their Medicare coverage can help narrow down their options. Of course, each plan’s coverage varies and talking to a Medicare expert will help ensure your parent is enrolled in the best plan for their needs.

Ask your parent the essential questions: 

Allow those questions to transform into a conversation in which you can fully understand your parent's position. 

#4 Check with Their Important Healthcare Providers

It is best to be proactive with their healthcare providers to avoid any hold-ups with your parent's care. 

A little-known fact is that health care providers must enroll in the Medicare Program to receive payment for covered services from Medicare. So, be sure to check with them to ensure that they are enrolled in the Medicare program. 

Additionally, some plans only cover services provided by doctors who are in-network. If your parent has a preferred provider, it’s important to make sure that they are in-network for the plan when doing a plan search. Our Medicare Advisors, for example, can search for plans by doctor to ensure that they only show you options that cover the desired physician. 

#5 Enlist the Help of a Medicare Expert

There's a lot of information out there about Medicare. If you're feeling overwhelmed while trying to help your loved one find the right Medicare plan, you're not alone. 

With all of the responsibilities that come with helping an aging parent, navigating the complexities of Medicare shouldn’t consume all of your time and energy. Consider turning to an experienced advisor who can help you compare options and guide you through the enrollment process. If you're simply looking for more information, learn more about how to help enroll your parent in Medicare.

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