Time to Help Mom Navigate Medicare

Last Updated Apr 10, 2009 1:29 PM EDT

Last night, I went to a dinner party where a geriatric care doctor was lamenting that most of her patients have no idea what Medicare covers or how it works. That's especially problematic today when many seniors may see their health insurance premiums rise next year and may feel forced to switch plans.
Earlier this week the government set its 2010 reimbursement rates for Medicare. As a result, those enrolled in private health plans, or the Medicare Advantage plans, could see their premiums jump as much as $40 to $70 a month next year or see a reduction in covered services.

While news of higher costs is never welcome -- especially during a recession -- it's even more troubling for those seniors that aren't able to evaluate their plan options and make smart decisions on their own. That's why if you have elderly parents -- or even younger ones who aren't particularly health care savvy -- it's critical you step in and try to help out.

Be warned: Medicare isn't something you can get up to speed on in just a few minutes. When my mother-in-law turned 65, she needed to hire a Medicare consultant to walk her through the various options for her and her husband. That's because unlike her employer's benefits manual, which was relatively straightforward, the government's health insurance forces seniors to make countless choices and doesn't offer very good instructions or price comparisons. And if she made a mistake, including missing an open enrollment deadline or choosing a bad supplemental plan, it would have cost her real money. Believe it or not, Medicare actually penalizes seniors for making simple mistakes.

So consider this your official warning. If you have elderly parents, now is the time to learn about Medicare so you can help your mother or father make the most cost effective decisions now and next year. Here's how you can get started.

  • First you'll need to figure out how Medicare works. For a primer, start off with the official Medicare website. It will walk you through what Medicare A, Medicare B and Medicare D are and then explain your options for supplemental coverage. But like any government resource, it will also probably leave you wanting more information. That's why I would also recommend you check out the Web sites of the Kaiser Family Foundation and the Medicare Rights Center, which offer more straightforward and comprehensive summaries.
  • Next, even though most seniors won't be able to sign up for a new Medicare plan until next year's open enrollment period, which starts in November, there are things you can do now to help your parents avoid excess costs. Find out, for example, if your mom's drug plan covers all of her medications? If not, make a note that she should switch plans next year. In the meantime, read my post on saving money on medications for some tips on how to find the most competitive prices for her pills.
  • Then find out if all of your parents' doctors accept their health coverage. Unfortunately, many health care providers are opting out of traditional Medicare and the Medicare Advantage plans. So you may need to encourage your parents to find new providers who do accept their version of Medicare insurance.
  • Finally, be aware that even if your parents are satisfied with their coverage today, you should still help them evaluate their choices next year as prices rise and benefit coverage changes. The government's Medicare Web site has two tools that can help you evaluate benefits and prices -- one for health plans and one for drug plans. And if you want to speak with an advocate, try calling the Medicare Rights Center.
If you've succeeded or struggled with your parents' Medicare , please leave a comment and any advice you'd like to offer other readers.