Three ways to help your parents avoid Medicare mistakesOctober 4, 2022
Three ways to help your parents avoid Medicare mistakes
Tips to help parents save money and get the best Medicare coverage for their lifestyle and needs
Champaign, Ill. – It is not uncommon for adult children to assist their naturally aging parents in navigating many of the age-related decisions they face. It is especially true when it comes to Medicare.
Beginning at age 65, Medicare is the primary way most people will meet their healthcare needs in retirement, but the complex system can be less than simple to understand. This is where adult children can make a difference. By using problem-solving skills to match their parents’ needs with the plans, options and other benefits available, adult children can help assure their loved ones walk away with coverage that fits their lifestyles, health status and budget.
But where to begin? Missing deadlines, delaying enrollment or choosing the wrong plan can cost your parents money and needed care.
Listed below are three significant ways you can help ensure your parents get the best Medicare coverage for their lifestyle and needs.
Tip #1 Learn the Basics.
Timing: The annual open enrollment period for Medicare runs from Oct. 15 through Dec. 7. It is the same time period every year.
- During this time those eligible can sign up for Medicare Advantage, change plans or change from Medicare Advantage to traditional Medicare
- The choices made go into effect on Jan. 1 the following year and decisions are generally locked in for that full year, with some exceptions
- Plans are for individuals; parents don’t have to be on the same plan. Plan selection should be based on personal needs.
Choices: Everyone has two broad choices for Medicare coverage – traditional Medicare and Medicare Advantage.
The differences between the two plan options are summarized below.
- Federally-funded health insurance program.
- Original Medicare includes Part A (hospital coverage) and Part B (physician and outpatient services). Coverage for Part D (prescription drugs) is purchased separately.
- Most participants receive Part A coverage for free, but everyone pays a premium for Part B coverage.
- Participants do not get coverage for things like routine dental, vision or hearing services.
- No yearly cap on out-of-pocket expenses.
- Medicare Supplement/Medigap policy can be purchased to help keep out-of-pocket costs down.
Medicare Advantage plan (also known as Medicare Part C)
- Replaces Original Medicare and it’s offered and managed by private insurance companies approved by Medicare.
- All-in-one plan that bundles Part A, Part B and often Part D coverage.
- Often includes additional coverage for routine vision, dental and hearing services plus extra wellness and care coordination benefits.
- May also cover benefits like transportation to doctor visits, coverage for fitness activities and discounts on over-the-counter items.
- Participants pay their Part B premium for their Medicare.
- Monthly premiums with some plans start at $0/month.
- Yearly limit on out-of-pocket costs for medical services.
- Cannot be combined with Medicare Supplement/Medigap policies.
“With a comprehensive Medicare Advantage plan, members are given the same convenient access to benefits all on one plan as they may have had from an employer,” says Terra Mullins, Director of Community Outreach with Health Alliance. “These Medicare Advantage plans are designed to work within a variety of budgets and often include additional coverage for fitness activities and discounts for over-the-counter items.”
Tip #2 Talk with your parents about their needs, must-haves and like-to-haves.
You may not be accustomed to talking with a parent about their health and finances, but having that conversation is important to understanding both their specific health insurance needs and what can be afforded. Talk with parents about their:
- Overall health – discuss medical history plus current and anticipated care needs
- Medications – even if a parent isn’t currently taking many medications now, a change in health or need for surgery can quickly lead to high medication costs, so pay attention to prescription drug coverage options
- Doctors – names of doctors regularly seen and hospital preferences
- Dental, vision and hearing care needs
Matching your parents’ needs to what different plans offer makes the decision process easier. Once you have the “must-haves” covered, focus on the “like-to-haves”. Medicare Advantage plans often include other benefits to help keep people well.
- Medicare Advantage plans often include additional coverage for routine vision, dental and hearing services, which Medicare Part B does not, and Health Alliance includes coverage for fitness activities and discounts for over-the-counter items
- Consider the out-of-pocket costs – determine if you are more comfortable with a yearly limit on out-of-pocket costs for medical services or are you are willing to purchase supplemental insurance to help defray some out-of-pocket costs
- People who liked the health insurance they had from their employer when they were working, might appreciate the one-stop-shopping convenience of a more comprehensive Medicare Advantage plan
- Medicare Advantage plans like some of the ones from Health Alliance offer plans as low as $0 a month and often meet a wide variety of members’ needs, wants and extras
Tip #3 Know where to turn for help.
Now is the time to compare Medicare plans and save — help is out there. Whether you determine a parent would do best on original Medicare or with an all-in-one Medicare Advantage plan, like those offered by Health Alliance, the focus should be on his or her health and wellness needs and which option offers coverage for the things that matter most.
Need more information about Medicare plans and enrollment?
- Call Health Alliance at 1-888-382-9771
- If you live around Champaign, visit the office at 3301 Fields South Dr., Suite #105, in southwest Champaign
- Go to HealthAlliance.org/Medicare
- Contact your local insurance agent