Navigating Medicare can be a challenge for seniors. While there are several major decisions to make when entering Medicare, there are also important tasks that need to be completed each year. Given that Medicare can be a bit confusing, it’s helpful to have a guide along the way. You can be that guide for your parents.
Help them learn their Medicare enrollment periods
Medicare consists of several parts and plans that beneficiaries piece together to make the most cost-effective coverage for their specific needs. With these various parts and plans come several different enrollment periods in which you can apply for them. Missing these enrollment periods can result in coverage gaps, lifelong late penalties, and more.
The first enrollment period you should help your parents identify is their Initial Enrollment Periods (IEP), which is based on their 65th birthday. This seven-month window is meant for enrolling in Medicare Part A and Part B for the first time. After the IEP, there are several other important enrollment periods your parents should be prepared for. Some only occur once, while others happen annually.
Analyze which type of plan fits their needs the best
There are two main types of Medicare plans your parents will need to compare. The purpose of these plans is to lower their out of pocket spending. These two types of plans are Medigap and Medicare Advantage.
Medigap (Medicare Supplement) plans and Medicare Advantage plans are extremely different from one another. For example, a Medigap plan has no network, while most Medicare Advantage plans have a network. Most Medicare Advantage plans have a built-in Part D plan, while Medigap plans do not.
These, along with other factors, are ones you’ll want to discuss with your parents to decide which route will likely be the most cost-effective and comfortable in the long run. Remember, what works for your mom may not be the best fit for your dad.
Compare plans with them once you know which type works best
Once you have determined together which type of plan works for each of them, it’s time to compare their available plans. Medicare Advantage plans vary by ZIP code and costs and benefits vary by insurer. Medigap plan benefits are generally the same in every state. However, Medigap plan premiums vary by zip code, gender, carrier, and even smoking status.
When comparing Medicare Advantage plans with your parents, you’ll want to review things like premiums, copays, deductibles, benefits, and provider networks. The good thing about Medigap plans is that benefits are essentially the same for each plan regardless of the insurance company. The main difference is the plan premium.
Gain a comprehensive understanding of Part D together
Medicare Part D is one of the most misunderstood parts of Medicare; it’s easy to make a mistake when enrolling in Part D. The more you and your parents learn about Part D ahead of time, the better off they will be each year to choose the right coverage
As mentioned earlier, some enrollment periods only occur once, and others happen annually. The Annual Election Period (AEP) occurs each fall and your parents can make changes to the Medicare and Part D prescription drug plan coverage.
Your parents will first each enroll in a Part D plan during their Initial Enrollment Period (unless they enroll in a Medicare Advantage plan instead). Then, every year during the AEP, your parents can comparison shop their Part D plan to ensure they are always enrolled in the most cost-effective plan available for the next year. Don’t just compare premiums, however, compare, deductibles, formularies, and provider networks, too.
Guide them through enrollment
The fifth way to help your parents navigate Medicare is by guiding them through their enrollment. You can assist them in applying for Part A and Part B, as well as their other Medicare plans, such as Medigap and Part D or Medicare Advantage.
Part A and Part B enrollment is done through the Social Security Administration and will be the same for each parent. However, Medigap, Medicare Advantage, and Part D enrollment are done through private insurance carriers. Working with a licensed Medicare broker gives you access to multiple different plans, so you and your parents can find the most cost-effective plans and get help enrolling in them.
Being your parents’ Medicare guide will help not only them, but also yourself. Once you reach Medicare age, the information won’t be brand new, and hopefully, you’ll have an easier time navigating Medicare when your time comes.