Helping Your Parents with Their Medicare Plan: A Step-by-Step Guide
Navigating Medicare can be overwhelming, especially when helping your parents make the transition. Whether they are aging into Medicare at 65 or coming off an employer plan, it’s crucial to ensure they make informed decisions to avoid penalties and gaps in coverage. Here’s how to guide them through the process.
Step 1: Determine Their Medicare Eligibility and Enrollment Period
Most people become eligible for Medicare at age 65. However, the enrollment process depends on their work history and current health coverage:
- If your parent is receiving Social Security benefits, they will be automatically enrolled in Medicare Part A (hospital insurance) and Part B (medical insurance) starting the first day of the month they turn 65.
- If they are not yet receiving Social Security, they must actively enroll in Medicare through the Social Security Administration.
✅ To enroll, visit:
- Social Security Website
- Call 1-800-772-1213
- Visit a local Social Security office
Step 2: Find Out If They Need Medicare Part B
If your parent is still working and covered under an employer group health plan, they may be able to delay enrolling in Part B without penalty.
🔹 Key Questions to Ask the Employer:
✔️ When does their group health coverage end?
✔️ Is their employer plan considered creditable coverage by Medicare?
✔️ Should they sign up for Part B now or wait until they retire?
⚠️ Potential Pitfall: If their employer has fewer than 20 employees, they MUST enroll in Medicare Part B when they turn 65. Otherwise, Medicare becomes their primary insurance, and their employer plan may not pay for claims.
Step 3: Sign Up for Medicare Part B (If They Haven’t Already)
If your parent is coming off an employer plan, they’ll need to enroll in Part B to avoid a lapse in coverage.
✅ To apply for Part B:
- Complete Form CMS-40B (Application for Enrollment in Medicare Part B)
- If they’re leaving employer coverage, their employer must complete Form CMS-L564 (Request for Employment Information)
- Submit forms to Social Security online, by mail, or in person
Step 4: Understand Their Medicare Coverage Options
Once enrolled in Original Medicare (Parts A & B), your parent has two main coverage options:
✅ Option 1: Medicare + Supplemental Coverage
- Medicare Supplement Plan (Medigap) – Covers out-of-pocket costs like deductibles and copays
- Part D Prescription Drug Plan – Covers medications
Best for: Those who want predictable costs and access to any doctor that accepts Medicare
✅ Option 2: Medicare Advantage (Part C)
- Combines Parts A, B, and often Part D into one plan
- Includes extra benefits like dental, vision, hearing, and gym memberships
- Uses a network of doctors (HMO or PPO plans)
Best for: Those who prefer a lower monthly premium and all-in-one coverage
Step 5: Enroll in a Medicare Supplement or Medicare Advantage Plan
Once they have Part A and Part B, they can enroll in either a Medicare Supplement or Medicare Advantage plan.
🔹 Important Enrollment Periods:
✔️ Initial Enrollment Period (IEP): 7-month window around their 65th birthday (3 months before, the month of, and 3 months after)
✔️ Medicare Advantage & Part D Open Enrollment: October 15 – December 7 each year
✔️ Medicare Advantage Open Enrollment: January 1 – March 31 (for switching Advantage plans)
✔️ Medigap Open Enrollment: Within 6 months of enrolling in Part B (guaranteed acceptance period)
⚠️ Potential Pitfall: If they miss their enrollment window for Medigap, they could be denied coverage or charged higher rates due to pre-existing conditions.
Step 6: Make Sure Their Medications Are Covered
If choosing a Part D prescription plan or a Medicare Advantage plan with drug coverage, check:
✔️ That their medications are on the plan’s formulary
✔️ That their pharmacy is in-network
✔️ The cost of their prescriptions under the plan
⚠️ Potential Pitfall: Not enrolling in Part D when eligible can lead to a late enrollment penalty added to their monthly premium for life.
Step 7: Be Aware of Important Medicare Deadlines
Here are key Medicare dates to remember:
| Medicare Enrollment Period | Dates | What You Can Do |
|---|---|---|
| Initial Enrollment Period (IEP) | 3 months before, the month of, and 3 months after turning 65 | Sign up for Parts A, B, and D |
| Special Enrollment Period (SEP) | Within 8 months of losing employer coverage | Sign up for Part B & Part D without penalty |
| Medicare Open Enrollment | October 15 – December 7 | Change Medicare Advantage or Part D plans |
| Medicare Advantage Open Enrollment | January 1 – March 31 | Switch Medicare Advantage plans or return to Original Medicare |
Step 8: Avoid Common Medicare Mistakes
🔸 Missing the Part B deadline → Penalty: 10% increase in premiums for life
🔸 Delaying Part D coverage → Penalty: 1% of the national average Part D premium for each month delayed
🔸 Not comparing plans annually → Plans change every year, and costs could go up
🔸 Choosing the wrong plan → Ensure it covers doctors, prescriptions, and services they need
Step 9: Get Help from Medicare-Planning Experts
Helping your parents with Medicare is a big responsibility, but you don’t have to do it alone. Our team at MedicareForMyParents.com can guide you through the process for free, ensuring your parents get the best plan for their needs.
📞 Need Help? Contact Us Today!
Email: info@medicareformyparents.com
Visit: www.medicareformyparents.com
We’re here to make the process easy and stress-free—because taking care of your parents’ Medicare shouldn’t be complicated. 🚀
