What Medicare Open Enrollment is so Important for Family Caregivers
Medicare Open Enrollment: The Time is Now
“Spending a little time now is paying off for all of next year,” says a message from Medicare.gov, the official website for Medicare, and it’s a very good piece of advice. This is the season of Medicare open enrollment, and it ends on December 7.
This is the time of year when Medicare recipients can change their plans. Your loved one’s health might have changed. A new illness could send them to new doctors. Their medications may have been changed. There might be a change in their finances, with less money to pay for medical bills. The government gives you a special time each year to enroll in a new plan to accommodate for these changes each year during open enrollment.
What Plan is your Loved One on?
Most people on Medicare are enrolled in Medicare Advantage plans, where you get your care within a network of doctors and hospitals.
Traditional Medicare is more expansive and expensive. You can go to any doctor or hospital enrolled in Medicare, but it costs more than Medicare Advantage. You need to pay a Part B premium for doctor bills, a Part D plan to buy your drugs, and a Medicare supplemental plan (also called Medi-gap), which will cover your 20% co-payment when you go to the hospital.
During Open Enrollment, someone over 65 who is enrolled in Medicare can keep their current plan or make a switch. Most people won’t change plans. Maybe the process seems too complex. Maybe they worry about doing the wrong thing. But this isn’t always the best option.
The Caregiver’s Role During Open Enrollment
As a caregiver you can’t be passive during Open Enrollment. Especially this year, when a flood of television commercials is pouring out promises, with relentless promotions from heroes of the Baby Boom generation. There is an unusual amount of promotion this year because there are additional plans and their promises are expanding in new ways. For example, for the first time, some plans are offering transportation to take you to a doctor’s appointment or shopping.
Your loved one may be swayed by celebrities like Joe Namath and Joe Montana, or George Foreman, or William Shatner telling them to call a number, where an agent will sign them up with a plan that has a plethora of new benefits. New plans can sound appealing: Perhaps the plan will provide someone who will drive your loved one to a doctor's appointment, or go out and pick up some groceries. Many plans will boast free dental care and a free gym membership, benefits you can't get under traditional Medicare.
Sorting through the different plans is confusing, and most people don't know what to do. As a result, they default to doing nothing, and they often don’t spend any time comparing plans. More than 50 million people are enrolled in Medicare Advantage plans, and 70% of them did nothing when enrollment was open in 2018 for the 2019 benefit year, according to the Kaiser Family Foundation.
Alternatively, some people can choose to switch without understanding the full picture. Some people are excited at the prospect of saving money and may pick a plan that excludes the doctors they are now seeing. Some people might have lost their doctors and their coverage for specific drugs because their current plans made changes. Plans are difficult to understand, with each one having its own network of doctors and hospitals. It’s important to be careful that you don’t enroll your loved one in a plan that causes them to lose coverage for their doctors.
What are the Top Reasons You Should Help Your Loved One Compare Plans?
1. Your Loved One’s Doctors May Not Be Covered Next Year
Your loved one’s doctors may have moved. They might be in the plan they have this year, but not in the new one where they are being enticed to enroll. The commercials look appealing and your loved one may call the number to get all those extra benefits. However, when the insurance agent makes a pich, tell them you want to keep all your doctors and to find a plan that will include them for the next year. Be sure to tell them where you live and the names of your doctors.
Don't sign up for anything until you are sure the new plan will include your doctors. Even then, don't take anyone's word for it. Call the doctor's offices, tell them which plan you are considering for 2022, and find out if they are participating in it
2. Your Loved One’s Mobility has Declined
Perhaps your loved one’s mobility has become limited, and they can't drive safely anymore. You and their other caregivers don’t live nearby to take them shopping or to the doctor's office. Some of the Medicare Advantage plans now offer transportation as a benefit. Check the plans to see which ones offer the benefit in your neighborhood.
Tips for Helping Your Loved One Compare Plans
Remember the average Medicare beneficiary has access to more than 30 different plans. New plans may be offering cheaper monthly premiums or even zero premiums. Sorting through them won’t be an easy task. The best thing you can do as a caregiver is to help your loved ones navigate Medicare’s tricky river of plans.
Remember: You need to be sure your doctors and your drugs are still covered and any other benefits you depend on are still in your current plan.
Bob Rosenblatt is a Senior Finance Reporter with 40+ years of experience, specializing in issues of aging, such as Medicare, Social Security, Pensions, IRAs, and Assisted Living.
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