Caregiver Corner: Helping your loved one prepare for the Medicare Annual Enrollment Period

Caregiver Corner is designed for those who are helping their loved ones make informed health care decisions. Whether you’re a main care provider or decision maker, Caregiver Corner can help you help your loved one.

Every year from October 15 – December 7, people who are eligible for Medicare can add, switch or drop their coverage. This is called the Medicare Annual Enrollment Period (AEP). Whether you’re officially a caregiver or just helping a loved one make Medicare decisions, it’s important to make sure your loved one will be ready once AEP rolls around. Here are some tips to help you help your loved one.

Are You Authorized?

Are you are going to help a loved one make Medicare decisions? Will you need access to their personal health information? If so, an important first step is to make sure you have the proper authorization. This usually requires you to fill out a form. Your loved one’s plan may have its own form, which you can usually find on the plan’s website. You might also need to use the Medicare Authorization form (PDF) on Medicare.gov. Contact your plan for more information.

Can We Talk?

As a caregiver, it’s important to maintain a good line of communication with your loved one and the health care professionals involved in their care. Talk openly and honestly about your loved one’s health status and care needs. Have these changed over the past year? Is their current coverage meeting these needs? Will they need to take advantage of the Medicare Annual Enrollment Period? Here are some questions you might want to start with:

  • What health care and prescription drug coverage does your loved one have?Do they have Original Medicare plus additional coverage? A Medicare Advantage plan?Tip: Check to see if your loved one is paying for benefits they aren’t using. There might be lower-cost plans available that only offer the benefits they need.
  • Which prescription drugs do they use?Have these changed over the past year? Will their current plan’s formulary cover them? Can they still go to the pharmacy that’s convenient for them and for you?Tip: Is your loved one taking any higher-tier drugs? If so, ask their doctor if there are lower-tier drugs they can use to help save money.
  • How about doctors and other health care providers? Does your loved one have a doctor they like to see? Have they added doctors or specialists to their care team in the past year? Are these providers in their current plan’s network?Tip: If you’re looking at new providers, it’s important to know the difference between “accepting (Medicare) assignment” versus just agreeing to see patients with Medicare.
  • Does your loved one have any home health care needs? If your loved one cannot leave their home, it might be time to think about home health care. Their doctor can help you decide if this is the right decision.Tip: Most Medicare coverage has specific requirements for home health care. Be sure to familiarize yourself with these rules—and whether or not your loved one’s current plan covers these services

What’s Available?

Knowing your loved one’s health care needs can help you determine if their current coverage meets those needs. Then you can decide whether they need to add, switch or drop coverage during the AEP. For a good general resource, check out the MMC Plan Type Comparison chart. This chart gives you the basics of the different types of Medicare plan so you can better understand what’s out there. Then, take a look at the Medicare.gov Plan Finder tool to compare plans available in your area—or your loved one’s—side by side.

Ready to Enroll?

Here are some things you might need to help your loved one prepare for AEP:

  • Personal Information: For example, your loved one’s birth date and contact information.
  • Insurance Information: You’ll need your loved one’s Medicare information. If they are a member of other insurance plans, you’ll need that information too.
  • Medical Information: It’s a good idea to make a list of the names and contact information for your loved one’s doctors and healthcare providers. Make a list of all their prescriptions, too, including dosages. It might also be helpful to make a list of your loved one’s health conditions and treatments.
  • Financial Information: Are you planning on setting up plan premium payment options for your loved one (like electronic funds transfer)? If so, you’ll also need to have their bank account information handy.

You can find a complete version of this checklist on the Medicare Made Clear website.

Care for Caregivers

Whatever caregiver role you play in your loved one’s Medicare decisions—coach, main care provider or decision maker—an important part of that role can be helping your loved one prepare for AEP. You will need to work closely with your loved one’s health care team, too—physicians, pharmacists, friends, community groups and financial advisors. Each of these people is there to help you prepare your loved one for AEP.

–This information is provided by Medicare Made Clear

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