What Should I Verify About My Parent's Medicare Plan Every Year?

What Should I Verify About My Parent's Medicare Plan Every Year?

Taking care of your parent’s Medicare plan is a big responsibility. Each year, you need to make sure their coverage and benefits are up-to-date. This yearly review helps ensure they have the best possible healthcare without any gaps or unexpected costs. Here’s what you should verify every year.

Check Their Current Coverage

Start by reviewing your parent's current Medicare plan to see if it still meets their health needs. Medicare offers different types of coverage, including Original Medicare (Part A and Part B) and Medicare Advantage plans (Part C).

Original Medicare covers hospital stays (Part A) and doctor visits (Part B), but you might need a separate prescription drug plan (Part D) for medications. If your parent has this setup, make sure both parts are still working well.

Medicare Advantage plans offer all the benefits of Original Medicare plus extra coverage like vision or dental care. These plans often include prescription drugs too, so you don’t have to worry about buying a separate Part D plan. Check if their current plan continues to cover everything they need and if there have been any changes in costs or benefits.

Review Their Prescriptions

Prescription medications can be a big part of your parent’s healthcare routine, especially as they age. Each year, you should review their prescription drug coverage to ensure it still fits their needs.

First, check the plan's formulary—the list of covered drugs. Make sure all the medications your parent uses are on this list and that there haven’t been any changes in how much they cost. Sometimes, a medication can move from one tier to another, affecting copays.

Also, be aware of coverage gaps and donut holes—periods when your parent might have to pay more for their prescriptions before the plan starts covering again. Understanding these periods helps you budget better and avoid surprises.

Look at Cost Changes

Healthcare costs can change every year, so it’s crucial to review any changes in premiums, copays, or deductibles. Even small increases can add up over time.

For Original Medicare, your parent pays a monthly premium for Part B coverage. They might also have a separate prescription drug plan (Part D) with its own set of costs. Check if these premiums and deductibles have gone up from the previous year.

If your parent is enrolled in a Medicare Advantage plan, their total out-of-pocket costs can vary depending on whether they stay within the plan’s network for care. Review the annual notice of change (ANOC) that comes from their insurance company. This document will detail any changes to premiums and cost-sharing requirements.

Explore New Options

Every year during the Annual Election Period (AEP), which runs from October 15 to December 7, your parent can switch or add coverage if needed. It’s a good time to explore new options and compare plans to see if there are better deals out there.

Start by checking what Medicare-approved plans are available in their area for the upcoming year. Use tools like the Medicare Plan Finder on Medicare.gov to search for different types of plans, such as Original Medicare with a Part D prescription drug plan or various Medicare Advantage plans.

Compare each option’s benefits and costs carefully. Look at premiums, deductibles, copays, and coverage limits. Consider any changes in your parent's health that might affect their needs. For example, if they recently started taking new medications, make sure the plan covers those drugs.

Conclusion

Reviewing your parent’s Medicare plan each year helps ensure they have the best possible healthcare without unexpected gaps or costs. Start by checking current coverage and prescriptions, then look at any cost changes and explore new options during the Annual Election Period. Staying on top of these details can provide peace of mind for both you and your parent.

Not affiliated with or endorsed by the federal Medicare program or any government agency.