When Loved Ones Need A Little Help With Managing Medicare
It’s one of the hardest twists in life to face, but many times adult children suddenly find themselves in the role of their parents’ primary support system. This can be a hard shift when it has always been the other way around. A loss of a loved one, a medical diagnosis, mobility issues, or slowing of cognitive behavior can all lead to the need for your loved ones to lean on you. And you aren’t alone. Caregivers need a guide when is comes to Medicare insurance decisions. Many often feel a responsibility and honor in caring for their parents or other loved ones. But, there can be a mix of guilt and frustration as you try to navigate work, family, and then add on the title, “Medicare Caregiver.”
During a focus group on Medicare and caregivers, one participant said, “It’s amazing how roles switch. If only I’d listened to my mother as much as I expect her to listen to me!” 1 In that same study, another participant noted that their relative only lets them see what they want them to see.
At Peel & Holland, our primary contact for Medicare beneficiaries is often an adult child or other caregiver. According to one study, at least 25% of adult 2 children caregivers said their parents needed help with healthcare information.
The problem? You probably already know the answer.
You don’t have time to fully research, you may only get half the story or paperwork from your parents, and you may not even know what questions you’re supposed to be asking when it comes to Medicare and your parents’ healthcare needs.
So, what do you do? What do you need to know?
5 Key Things Caregivers Need to Know About Medicare
- You can make changes to Medicare, so take some of the pressure off yourself as you try to make the best decision for your parent. Every year there is an open enrollment period from October 15 through December 7. This is a great time to sit down and talk with a licensed insurance agent, even if you’ve never done this before. This is the time allotted to change their Medicare Advantage and Prescription Drug Plans for the new year.
- Peel & Holland Insurance agents are trained and tested in medicare. So you know you’re talking with a local licensed insurance agent, someone who cares for you and your future health needs. We work for you, not a single insurance company. That means we represent many different insurance providers, so you’re choosing which is best for your loved one, not what’s best for the insurance agent’s pocket.
- If you’re under a time crunch, you do have local resources available to you. There are online resources for you such as the Medicare and You handbook, but talking with a licensed insurance agent may allow you to get to the answers you need in a timely manner. Contact a Peel & Holland licensed insurance agent to set up a no-cost, no-obligation meeting.
- Remember, you are not the beneficiary, your parents are. This means their needs are most likely different from yours. That’s why it is important to think through their medications, their long-term care plans, their lifestyle, and current health issues before deciding on the right Medicare plan for them.
- There are certain time constraints, and they’re non-negotiable. If your parent just turned or is turning 65 soon, you may not have the time you normally dedicate to research important decisions like this. The initial enrollment period for Medicare is a 7 month window (3 months before they turn 65, the month they turn 65 or within 3 months of their birthday). Here’s the key thing to remember: If you miss this window, then they may have some monthly penalties (not a one time penalty, but a monthly extra payment). If you do miss their initial enrollment deadline, then they will need to wait until the January 1- March 31 General Enrollment Period. But, give a local insurance agent a call to begin discussing what’s best or if there are special circumstances that may allow you to go ahead and enroll your parent.
How to Initiate Assistance With Medicare Decisions
Now that you know the timeline, this makes it a little easier to ask a few inquiring questions to see where your loved one is in the process of signing up or making changes to their Medicare plan.
Remember, your parent may be struggling with giving away independence or even the thought that they need help. Here are a few conversation starters to help you, the Medicare Caregiver, break the ice:
- “Hey Mom, I’ve been hearing a lot about Medicare lately, have you started that process yet?”
- “Happy almost 65th birthday, Dad! When does your Medicare coverage start? Did you already meet with someone about that?”
- “I wish insurance wasn’t so complicated! Maybe we should work together and go through your Medicare plan options for next year?”
- “I’ve heard about how frustrating and complicated Medicare is. I wonder if we should go talk with a local expert to see what they have to say?”
Peel & Holland Insight:
We often work with the eligible person’s loved ones. This can be tricky, but we take extra care to balance the needs of all involved, helping them feel secure and confident in their choices. Talk about empathy for the caregiver! Medicare selection is one area where having a neutral expert is best. – Jill Lewis, Licensed Insurance Agent, 270.527.6168
Misconceptions Your Loved One May Have Regarding Medicare
In the study mentioned previously, many “believed that joining a plan meant leaving Medicare or that once you joined you could not switch back to Original Medicare or another HMO.” That’s simply not the case. This is the purpose of the Annual Enrollment Period for Medicare. Beneficiaries can make some changes to their Medicare plan during this time.
Your parent (or loved one) may say that since they’re still working and have insurance then they have no need for Medicare right now. That’s not necessarily true. Even though they may still have insurance through their work or their spouse’s work, they may still want to sign up for Part A (Hospital Insurance) because usually this is provided at no cost. However, they may want to wait to add Part B and Part C since these would charge a monthly premium. Your parent will have 8 months after they or their spouse stops working to sign up for Medicare. This is considered a Special Enrollment Period. But, they will want to sign up for these plans at least one month before retirement, so there is no gap in healthcare coverage. If you’re not sure when they should enroll, this is a quick questionnaire that will get you answers. Or just call us to discuss their particular situation.
Protect Your Parent From Medicare Fraud
We will be the first to tell you that being cautious is the best path toward keeping your information and your identity safe. Even with us, it’s OK to ask questions and we honestly welcome it. Sadly, there are many fraudsters and dishonest agents out there who will take advantage of your parent. That’s why we wanted to briefly make you aware of some signs to look for.
- Is someone pressuring your parent to join at their very first meeting or before they’re ready to make a decision?
- Did an agent come to their house or call them unsolicited?
- Are they receiving any type of equipment or bills in the mail of services they did not request?
The Center for Medicaid and Medicare Services offers more information about Medicare fraud in the video below:
Resources To Help You Navigate Medicare As A Caregiver
You’re not alone in this process! While there are call centers and government resources, we find it comforting to know you have a local, licensed insurance agent you can talk to.
We are trained in Medicare plans and are here to help you find what’s best for your loved one’s needs. Keep in mind, we are not paid by you or your parent, but by the insurance provider after a plan is chosen. Talking to us costs you nothing. The unique thing about working with us is that we don’t just represent one insurance company, but many. We’re here to help build plans that will actually cover what our clients need or expect needing.
If you’re not sure why calling Peel & Holland should be at the top of your to-do list, then check out this article about the 6 reasons why you should call a local Medicare expert.
A few other resources to check out
- If you need to get access to your parent’s personal health and Medicare information, then you’ll need them to sign this document from the Center for Medicaid and Medicare Services.
- Medicare And You Booklet is provided by Medicare.gov to help you better understand your rights and options with Medicare.
- Don’t let normal acronyms and terms confuse you during this process. We’ve created a simple glossary of terms that you might see online or hear in a meeting with one of our licensed insurance agents.
Schedule Consultation With a Local Agent
1, 2National Library of Medicine: Family Members and Friends Who Help Beneficiaries Make Health Decisions