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.
1. 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. 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.
2. 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, care needs and what Medicare coverage they have. 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.
If your loved one has a private Medicare plan, they’ll get an Annual Notice of Change each fall (usually in September). When you receive that, we recommend reviewing it together and using the questions below to help identify next steps.
Here are some questions that may help guide your conversations:
- What kind of coverage does your loved one have? Is it Original Medicare (Parts A & B) or a Medicare Advantage (Part C) plan?
- What benefits does your loved one have? Which do they actually use? 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.
- How are they getting prescription drug coverage? What prescription drugs does your loved one take regularly? Look at if they get prescription drug benefits from a stand-alone Part D plan or a Medicare Advantage plan. Look at the different medications they take and how often. Check to make sure these prescription drugs are covered on the plan’s formulary. If they aren’t, you may need to shop around for a new plan.
- 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 exists? 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, you’ll have what you need to determine whether your loved one’s current Medicare care plan is a good fit or if you should research plan options.
3. Gather Your Loved One’s Medicare and Other Information
Before researching Medicare plans, it’s a good idea to gather up the following personal and medical information. You’ll need it to enroll, and it can make things easier 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.