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Many adults find themselves helping their aging parents with Medicare, a complex process with many steps and considerations. There are penalties for delaying enrollment, and not everyone understands their options when they get sick or change plans.
“You can’t go into it thinking it’s really easy,” says Melinda Caughill, co-founder of 65 Incorporated, which offers guidance on Medicare. “It is incredibly complicated, and the decisions your parents made, or will make, will affect you.”
Being proactive and getting as much information as possible can help. Try these tips to be the best advocate for your parents when and if they need your help.
Get neutral advice
If you have questions, start with someone who isn’t trying to sell you (or your parents) anything. “People should not make their first stop an insurance agent or an insurance company,” Caughill says. “Do they have your best interests at heart? To a point. But at the end of the day, they have to pay their bills just like everybody else.”
If you can afford it, a Medicare adviser or advocate is a helpful resource. (Try searching online for “fee for service Medicare advisers.”) Caughill suggests budgeting $500 to $1,000 for this kind of advice.
Related: How to have ‘the talk’ with your aging parents
If that’s not an option, consider reaching out to your State Health Insurance Assistance Program, or SHIP. You can find yours at shiphelp.org.
“In every state, they provide free, local and unbiased information to people who are aging into Medicare, people who are already Medicare recipients, their families and their caregivers,” says Micki Nozaki, director of California Senior Medicare Patrol for California Health Advocates. “If they don’t have all the information, they can point you to other resources.”
There’s also a great deal of information on Medicare.gov. You can familiarize yourself with the program by downloading the “Medicare & You” handbook. (Be prepared, it’s lengthy.)
Shop for insurance, not perks
When people are shopping for Medicare or changing plans, they can get distracted by the extras. “People get so focused on ‘my free gym membership’ or ‘my $50 gift card to Walgreens’
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that they forget about what really matters,” Caughill says. “Medicare is health insurance.”
Make sure your parents’ medications are covered. Make sure their doctors are in network and that those providers will take the coverage being purchased. “The reason you have health insurance is so if you get cancer, if you have a car accident, if you have Parkinson’s [disease] or you’re hospitalized,” you’re covered, Caughill says.
See: Drug prices rising as 2022 begins
Watch the calendar
Signing up for Medicare is time-sensitive; it usually happens around age 65. “One of the most essential things people don’t understand is that if they don’t enroll in the correct time frame — and it’s rigid — they might incur a penalty for the rest of their lives,” Nozaki says.
Depending on the situation, there can be late enrollment penalties for Medicare Part A, Part B and Part D. In many cases, you’ll be charged that penalty for the rest of your time enrolled in Medicare. Check Medicare.gov for enrollment deadlines that apply to your parents, because initial enrollment is birthday-specific.
See: Signing up for Medicare? Watch out for IRMAA
Read the fine print
Your parents may be able to delay signing up for Medicare Part A or Part B, depending on their situation. For instance, if one or both are still working at age 65 and they’re covered by employer-provided health insurance, they may be able to wait to sign up.
Also read: Social Security redesigned your statement, here’s why you should take a long, hard look at it
That said, the rules are extremely specific, including how long they’d have to enroll once they stop working or lose that employer coverage. Make sure you (and they) fully understand when they must sign up. Visit this Medicare fact sheet for more information.
Be careful of scammers
Medicare beneficiaries are a popular target for fraudsters, so help your parents protect themselves by making sure they understand the following:
- Medicare doesn’t call people to sell them things.
- Medicare can’t enroll you in a plan over the phone unless you initiate contact.
- Medicare will never call and ask you for your Medicare number unless you’ve given them express permission ahead of time.
- Your Medicare number is important. Tell your parents to protect it like it’s a bank account or credit card number.
“I know it sounds simple and it sounds like common sense, but unfortunately these telemarketers are so clever and conniving that when they masquerade as Medicare,” Nozaki says, “people do believe they’re getting a call from Medicare.”
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Kate Ashford writes for NerdWallet. Email: kashford@nerdwallet.com. Twitter: @kateashford.
