9 Simple Steps to Help Your Parents or Loved Ones Get the Best Medicare

Medicare can be a scary thing! It seemed so confusing to me in the beginning. Having all your ducks in a row can ensure those you care for (and maybe even yourself) will be covered completely. Our guest blogger Danielle K Roberts offers 9 simple steps to conquering Medicare we should all take! Please note, that working through an insurance broker is definitely an option, however it is not required or always necessary.

By Danielle K Roberts

Anytime someone is first learning about Medicare, the whole process can seem very confusing. It can be equally as overwhelming for adult children who dive in to help make sure their parents have the most cost-effective coverage. Fortunately, if you know the basics, Medicare becomes a much easier system to navigate. Here are 9 simple steps to follow to make sure that your parents are always getting the best coverage for their personal needs and budget.

 1. Learn the Parts of Medicare

Before you can help your parents sort out their supplemental coverage options, you first need to understand the basics. Medicare has two parts. Part A is their inpatient hospital benefits and Part B is their outpatient medical coverage. While Part A costs nothing for most people with a work history in the U.S., Part B has a monthly premium.

Part C is the Medicare Advantage program, which is an option for your parents to elect to get their Medicare coverage through a private insurance company instead of from the federal government itself. 

Part D is optional prescription drug coverage to help cover medications costs.

 2. Educate Yourself on the Two Main Insurance Options

Medicare does not cover 100% of all healthcare services. Your parents will be responsible for deductibles, copays, and coinsurance when they use their medical benefits. Many individuals enroll in supplemental coverage to help pay for these items. Medicare supplements are policies which pay after Medicare to cover the gaps. There are 10 standardized plans to choose from in most states.

Typically Medicare supplements have higher premiums with lower and more predictable spending on the back end of the policy. Beneficiaries can access any Medicare provider in the nation with no referrals needed. Medicare Advantage plans, also called Part C Plans, are private insurance policies which pay instead of Medicare. The enrollee agrees to get healthcare services from the plan’s network of providers and pays copays as services are given. These plans usually have lower premiums but more frequent co-pays and expenses on the back end as the member accesses healthcare services. 

 3. Consider Medical Usage

Deciding which type of coverage will work best for your parents is tricky. If a beneficiary uses healthcare services often, a Medigap plan might be a good bargain because there are fewer copays. On the other hand, with low medical usage might appreciate paying a lower premium because they do not access medical services often. For these individuals, a Medicare Advantage plan may be appealing.

4. Ask them about their Peace of Mind

If worry over potential medical bills might prevent them from seeking treatment, then a Medigap plan eliminates that worry. You can select a plan where you know exactly how much coverage you have. Other people might feel more comfortable with less money being drawn out of their bank account each month for premiums. A Medicare-Advantage plan makes sense for people like this. Check with their Important Providers

5. Check with their Important Providers

Another factor to consider is whether your parents’ important providers accept the type of coverage you are considering. People on Medigap plans can see any Medicare provider. If considering a Medicare Advantage plan, check with providers to see if they participate in the plan’s network

 6.  Enrolling Through a Medicare Insurance Broker is an Option

A Medicare insurance broker can explain plan options and can help you do some of the legwork on checking with providers and making sure that their medications will be covered under their chosen Part D plan. Beneficiaries can also call the broker for free help when any benefits questions or claims problems occur.

7. Put an “Authorization to Disclose” on File

You may need to occasionally call Medicare on behalf of your parents. The representatives there must have written permission from your parents for you to speak with them on your parents’ behalf. Complete an Authorization to Disclose and mail it into Medicare.

8. Organize their Paperwork

It’s not uncommon for a beneficiary to have a Medicare card, a Medicare supplement card and a Part D drug plan. All three entities will send mail throughout the year. Organize their paperwork into separate files so that you can easily find the right information when you need it.

9. Shop their Policies Every Year

Medicare drug plans have different premiums, copays, networks, and drug formularies. It’s important to keep an accurate list of medications so that you can analyze plans yearly to make sure that the plan will still be so that every year during the fall Annual Election Period, you can shop your parents’ drug plan (or Medicare Advantage plan, if they have one). Sometimes changing plans will offer considerable savings.

Danielle K Roberts is a Medicare insurance expert at Boomer Benefits, where her team helps people new to Medicare with their annual Medicare decisions.