How to Help Your Grandparent Enroll in Medicare
If you’re in a position where you suddenly have to deal with caring for a parent or a grandparent, it can feel like countless responsibilities are thrust upon you at once, and there’s no training manual. You want to make sure you’re taking care of everything that needs to be done, but that can be very overwhelming, especially at certain ages.
One of the tougher aspects is simply not knowing what you don’t know. There are dead for certain things, or forms that need to be filled, or appointments to schedule. Depending on the cognitive abilities of the person you’re caring for, you may or may not get much help with this, so it becomes your responsibility to stay on top of 1000 and 1 different things.
We’re here to make one aspect of this challenge easier for you, and that’s healthcare. Getting your loved one enrolled in Medicare helps protect them against the many health issues one can face, especially later in life. Healthcare is a huge topic, and sometimes a controversial and confusing one, but we’re here with facts that will help you make an informed decision when it comes to choosing healthcare for a parent or grandparent, especially if they aren’t able to make these types of decisions for themselves anymore. You’re doing something great and selfless by taking on this task, so let’s go over what you need to know and how to get them setup with the healthcare that they need.
Do you have legal authority?
It’s okay to help your grandparent sign up for Medicare, but depending on your state you may be required to have authorized representative status before Social Security can proceed with the application. This includes “Durable Power of Attorney for Health Care”, “Health Care Power of Attorney” or similar legal authority. If they haven’t given you power of attorney to make decisions and actions on their behalf, you can still help them out with filling in the forms, knowing what information they need to gather, when to apply, choosing between Medicare and Medicaid for seniors, whether or not they should invest in dental coverage, and more.
What type of coverage does your grandparent need?
When deciding on the right Medicare health plan, it’s important to determine what level of coverage your grandparent will need. This will be based largely on their current health and medical needs, but you should also consider the potential for further health concerns down the road. It’s important to note that Original Medicare (Part A & B) doesn’t include prescription drug coverage or other benefits like vision and dental, so you may need to look into Medicare Advantage or Medicare Part D plans.
When deciding on the right plan for your loved one, consider the following information:
- Is prescription drug coverage necessary?
- What are their current health needs?
- Is nursing home care required?
- How often will hospital/outpatient care be required?
- Will they require frequent medical attention?
- Is vision and dental coverage important?
The answers to these questions will vary from person to person and family to family, and the answers will have a large influence on which plan you go with.
Do they already have a Primary Care Physician?
Some types of Medicare plans are limited to medical services within a certain network. If your grandparent already has a Primary Care physician that they see regularly, it is a good idea to look at Medicare plans that fall within their doctor’s network.
What prescriptions do they take?
Original Medicare doesn’t include prescription drug coverage, so if your grandparent takes prescription medication to stay healthy you will want to look at optional Medicare Part D coverage or Medicare Advantage plans. Even if they aren’t taking any prescription medications, it’s a good idea to consider enrolling in a plan anyway as your grandparent will avoid potential late enrolment penalties and will be prepared in the event their health begins to deteriorate.
Before choosing a plan, you and your grandparent should compile a list of their current medications. You can compare this list to the plans you are considering to ensure everything will be covered. Additionally, you should ensure your grandparent’s pharmacy falls within the coverage window to avoid loss of coverage or switching pharmacies.
What is their monthly budget?
Your grandparent’s budget is important when deciding on a Medicare plan. Plans that include more coverage typically cost more, but sometimes you may be able to find a deal, especially with Medicare Advantage plans.
Are they already enrolled in a healthcare plan?
If your grandparent is already enrolled in a healthcare plan that offers better coverage than Medicare, they shouldn’t sign up yet. Otherwise they will lose access to these benefits once their Medicare coverage becomes active.
If you (or your grandparent) are concerned about late enrollment penalties, Medicare has a special enrolment period for individuals with valid health insurance that will help them avoid additional fees.
When to Enroll in Medicare
There are certain deadlines to know when it comes to enrolling in Medicare. It can be tricky to figure out, so here’s a quick guide.
Initial Enrollment Period (IEP)
Most people are eligible for Medicare when they turn 65. The initial enrollment period lasts a total of seven months, starting three months before a person’s 65th birthday, includes the birthday month, and ends three months after their 65th birthday.
To avoid a delay in coverage, it’s best to enroll right away. If your grandparent enrolls during their IEP, they will avoid late enrolment penalties.
General Enrollment Period (GEP)
The general enrollment period runs from January 1 to March 31 of every year. During this time, a person can enroll in Medicare Part A and/or Part B but unlike the IEP, they may be required to pay a late enrolment fee which lasts for the duration of their coverage.
Special Enrollment Period
If an individual is enrolled in Social Security or has valid health coverage, they should qualify for a special enrollment period. This allows them to avoid late enrollment penalties and they won’t be required to enroll during their IEP or GEP.
The special enrollment period begins when the prior health coverage ends and lasts for eight months.
Set an alarm on your phone for slightly before this period because it’s just a lot easier to get it done on time instead of having to pay penalties or rush around at the very last minute.
How to Enroll in Medicare
There are a few ways to help your grandparent enroll in Medicare:
- Online: Through the Social Security website: www.ssa.gov
- Phone: Contact Social Security at 1-800-325-0778
- In-person: Visit your local Social Security office
Before doing that, take a look at our more in-depth post about how to apply for Medicare.
What’s next? What else do you need to know?
There are many other areas of senior care that you’ll need to learn about that aren’t related to Medicare. Are you responsible for their finances? If so, you can setup automatic payments for their bills (telephone, cable, utilities, etc) to ensure that there’s never a lapse in service. If they’re living with you, you’ll want to understand their prescription medications, any possible drug interactions, who their primary physicians are, and so on. It’s a lot to do all at once, and it won’t always be easy, but it’s something very admirable to help with.
Make sure you don’t get overwhelmed, burnt out, or neglect taking care of yourself. When an airplane is crashing, the caretaker is always advised to put their own oxygen mask on first, and then to put masks on their children or other passengers who need assistances. That’s because the caregiver can’t give adequate care if they aren’t taking care of themselves first, and this doesn’t just apply to an airplane emergency, this is also the case when it comes to caring for someone in their day to day life.