| Mon, Jul 22, 2019 @ 12:42 PM

How Caregivers Can Help Loved Ones Prepare for the Medicare Annual Enrollment Period

Posted by Medicare Made Clear

Caregiver information

Every year from October 15 to December 7, people who have Medicare can change their coverage choices for the following year. This time period is called the Medicare Annual Enrollment Period, or AEP for short.

Caregivers often find themselves in a position to help a loved one make Medicare decisions, so it’s important to be ready once AEP rolls around. Here are some tips to help you help your loved one.

Get Authorized to Obtain Your Loved One’s Personal Health Information

Will you need access to your loved one’s personal health information? If so, an important first step is for your loved one to fill out and file a Medicare Authorization Form (PDF). All the directions are on the form. Your loved one may also need to file for authorization with their Medicare plan. Contact the plan for more information.

Understand Your Loved One’s Health Care Needs and Medicare Coverage

As a caregiver, it’s important to maintain good 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. This can help you and your loved one decide if you’ll need to take advantage of AEP to get new or different coverage for the care they need.

Here are some questions that may help guide your conversations:

  • What coverage does your loved one have? Is it Original Medicare (Parts A & B) or a Medicare Advantage plan (Part C)? What additional coverage do they have, such as Medicare supplement insurance or a standalone Medicare prescription drug plan (Part D)? While you’ll want to make sure your loved one has adequate coverage, you’ll also want to check that they aren’t paying for benefits they aren’t using. It’s always a good idea to see what other plans are available that might meet their needs more closely, may cost less or both.
  • What prescription drugs does your loved one take regularly? Have these changed over the past year? Are all of their medications on their current plan’s list of covered drugs (formulary)? Is the pharmacy that’s convenient for your loved one and for you in the plan’s network? Also be sure to check what formulary tiers your loved one’s medications are on. If any are in a high tier, which means they cost more, ask their doctor if there are lower-tier drugs they can use to help save money.
  • Which doctors and other health care providers does your loved one like to see? Have any new doctors or specialists been added to their care team in the past year? Are these providers in their current plan’s network, if any? If not, do they accept Medicare assignment, which means that the provider agrees to accept the Medicare-approved amount for the services they provide?
  • Does your loved one have home health care needs? 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

With this information, and notices from Medicare and your loved one’s plan about any upcoming in cost or coverage, you’ll have what you need to research plan options. Medicare’s Plan Finder is a good place to start.

Gather Your Loved One’s Medicare and Other Information

Here are some things you might need when it comes time to enroll in or switch plans during 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.

For more information about Medicare, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.