It is important to consider the following to help a parent or caregiver get the most appropriate healthcare coverage:
- whether they have existing health conditions that require regular care
- their future healthcare needs and any potential conditions that could require management
- short- or long-term medications
- whether they may benefit from any specific services, like dental or vision
Once a person has a good sense of their parent’s current and future health needs, they will have a better idea of the most suitable Medicare plans when researching the different options.
Original Medicare comprises Part A, which covers inpatient care, and Part B, which covers outpatient services.
Both parts have out-of-pocket expenses, including premiums, deductibles, copayments, and coinsurance. Most people are eligible for premium-free Part A, though.
Original Medicare plans include limited prescription medications, but a person’s parents can choose a stand-alone Part D prescription drug plan for more comprehensive coverage.
Additionally, if a person’s parents have Original Medicare, they can consider a Medigap plan (Medicare supplement insurance) to help with some of Original Medicare’s out-of-pocket expenses.
Private health insurers administer Medicare Advantage plans that combine the benefits of Original Medicare’s Part A and Part B. Most plans also include prescription drug coverage.
Medicare Advantage plans usually provide extra benefits, such as optical, dental, and fitness.
Out-of-pocket costs can include monthly premiums, deductibles, copayments, and coinsurance, but these can vary by plan, insurer, and location. A person’s parents must still pay the Part B premium directly to Medicare.
A person can help their parents compare Original Medicare and Medicare Advantage benefits to find what works best for them.
A person can contact Medicare directly to discuss plan options for their parents or caregivers. They are available at 1-800-633-4227 (TTY: 877-486-2048) 24 hours per day, 7 days per week, excluding some federal holidays.
Alternatively, the State Health Insurance Assistance Program (SHIP) can offer impartial advice on most Medicare-related matters, so their guidance could be valuable when choosing the right plan for a person’s parents.
People can contact SHIP at 877-839-2675 or use their regional office locator to visit them in person.