By Ross Blair, CEO of Plan Prescriber
An estimated 2.8 million baby boomers turn 65 this year putting even more pressure on a growing number of family members and friends as they help loved ones face the daunting task of enrolling in Medicare for the first time. Consider these facts from the National Alliance for Caregivers:
- 43 million Americans provide unpaid care to family members or friends age 50 and older.
- 64 percent of these caregivers also manage these friends’ or family members’ finances.
- 26 million of these caregivers are full-time workers; that’s 16 percent of the American workforce.
Many baby boomers need advice the first time they enroll in Medicare. And, many adult caregivers face the same challenges when they try to help family members review new or existing Medicare coverage, or understand changes from one year to the next. For baby boomers and caregivers, it’s becoming increasingly difficult to navigate the complexities of a system that isn’t getting any easier to understand.
Finding your way through the Medicare maze can overwhelm anyone, especially with all of Medicare’s moving pieces. Medicare has four parts and ten supplemental coverage options. For example, Medicare Advantage plans include different benefits and provider networks, which should be compared. Prescription drug plans change each year to counteract rising drug costs, and each of the ten supplements has different coverage levels that should be evaluated.
So, what’s a caregiver to do? The good news is there are plenty of resources and comparison tools available to help you. Here are some things to keep in mind when you enroll:
- Manage timelines effectively. Most people become eligible for Medicare when they turn 65. There is a seven-month “initial enrollment period” that begins three months before their birthday month and ends three months after it. During that time, a person can enroll in Medicare Parts A and B, a prescription drug plan (Medicare Part D), or a Medicare Advantage plan. The open enrollment period for Medigap policies (supplemental insurance) starts the first month a beneficiary is both 65 and enrolled in Part B and lasts for six months.
- Avoid penalties. If you’re late enrolling in Original Medicare or a Medicare prescription drug plan (Part D), you may incur a permanent late penalty. Anyone who isn’t working, doesn’t have insurance from an employer or lives abroad, should enroll in Medicare at age 65. A person who still works and gets health benefits from an employer needs to enroll in Original Medicare within eight months of their retirement , even if they have COBRA benefits or if their employer provides retiree health benefits. And, if you enroll late for a Medicare Supplement plan, insurers have the ability to deny your application for health insurance coverage.
- Know your loved one’s prescription drugs. Compile a list of their current prescription drugs, including names, dosages and frequency. Once you have that list, use the prescription drug plan comparison tool at PlanPrescriber.com to compare prescription drug plans and help the beneficiary enroll online or over the phone.
- Obtain consent and don’t overlook legal matters. If you’re a caregiver for a loved one and you’re meeting their doctor to discuss their treatment, without them, have them sign a consent form giving their doctor the legal ability to discuss their medical needs with you. At some point, you may want to consult with an attorney to see if you need your loved-one to grant you or another family member a “durable power of attorney” that includes the ability to make decisions relating to their health care. Talk about who will take on this important responsibility and if your loved one has specific medical preferences or directives they want followed. Don’t wait for a health crisis to make these types of decisions.
- See if you qualify for financial assistance. If you provide unpaid care for a family member or friend, you may qualify for a small regular payment for your work. If the person you’re caring for is eligible for Medicaid, a program called “Cash and Counseling” might also be available. Call Medicaid or visit http://www.cms.gov/home/medicaid.asp to find out. The same holds true if you’re caring for someone with long-term care insurance that includes home care coverage. Call the insurer to ask about this benefit and any possible restrictions.
- Caregiving is a marathon so pace yourself. Caring for a loved one receiving Medicare can be a long-term task. Always remember that that preserving your own health is just as important as caring for someone else’s. Be sure to balance caregiving with personal needs. And, take time out to nurture your interests and tend to your health. You and your loved one will be better off for it.
The Centers for Medicare and Medicaid Services (CMS) has neither reviewed nor endorsed the information provided in this article.
(1) ‘Caregiving in the U.S. 2009,’ full report: http://www.caregiving.org/data/Caregiving_in_the_US_2009_full_report.pdf <http://ctt.marketwire.com/?release=759287&id=343744&type=1&url=http%3a%2f%2fwww.caregiving.org%2fdata%2fCaregiving_in_the_US_2009_full_report.pdf>.