Helping a loved one with Medicare

Where to start

Stepping in to help with someone’s Medicare can feel overwhelming, but it gets manageable once you have the lay of the land. Begin by gathering the basics in one place: their red-white-and-blue Medicare card, any plan cards (a drug plan, a Medigap policy, or a Medicare Advantage plan), a list of their doctors and pharmacies, and a current list of their medications. That picture tells you most of what you need to start making good decisions with them.

Understand their coverage

The single most useful thing to pin down is whether they have Original Medicare (often with a Medigap policy and a separate Part D drug plan) or a Medicare Advantage plan. The two work very differently — networks, costs, and how to change them all depend on which one they have. It’s also worth checking whether they qualify for help with costs, since many people who are eligible never apply.

Managing things over time

Most of the ongoing work is a rhythm, not a crisis. Mark the Annual Enrollment Period (October 15 to December 7) on the calendar, and watch for the Annual Notice of Change each fall, since plans change every year. Keep an eye on bills and explanation-of-benefits notices for errors, and know that decisions can be appealed. To handle calls and paperwork smoothly, you’ll want formal permission to act on their behalf — our guide to becoming an authorized representative walks through how.

Where to get help

You don’t have to learn everything about Medicare overnight. Every state has a State Health Insurance Assistance Program (SHIP) that offers free, unbiased counseling, and a licensed insurance agent can help you and your loved one weigh plan options without any cost to you. Leaning on those resources is the norm, not a last resort.