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Resources

How to Choose Medicare Benefits for a Family Member or Loved One

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Reviewed by:
Brett Braithwaite

Key Takeaways

  • If your parents need assistance, adults can name a personal representative of their choosing, which would make that person their health care power of attorney and their personal representative.
  • The most common time to change your parent’s Medicare plan is during the Annual Enrollment PeriodThe Annual Enrollment Period (AEP), also known as the Medicare Open Enrollment Period, allows you can enroll, change or drop Medicare coverage. The period takes place from October 15 through December 7 each year; changes take effect January 1. (also known as the Open Enrollment Period), which is from October 15 to December 7 each year.
  • If your parent is an eligible veteran, they may qualify for additional V.A. benefits and coverage.

Before you help choose a parent’s Medicare plan, it’s important to know the basics.

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What Costs are Covered by Medicare?

Medicare covers most but not all costs associated with medical and hospital services. After enrolling in Original Medicare (Parts A & B), you have the option to switch to a Medicare Advantage (Part C) plan.

The Parts of Medicare & What They Cover

Covers inpatient care in a hospital, skilled nursing facility, nursing home, hospice care, and some home healthcare

  • Covers medically necessary services that treat or diagnose your medical condition
  • Covers preventative services that prevent illness or help detect it at an early stage
  • Long-term care, most dental care, eye exams, dentures, cosmetic surgery, hearing aids, and routine foot care
  • Alternative to Original Medicare from private insurance carriers.
  • Must at least match Part A and Part B coverage
  • Medicare Advantage Prescription Drug plans include Medicare Part D coverage for medications
  • Most plans offer other benefits that Original Medicare does not
  • To make the most of your benefits, you must see providers who are in your plan’s network
  • Prescription drug insurance
  • You can use an insurance carrier’s network of pharmacies to purchase your prescriptions at the lowest cost

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Does the Veteran Status Provide More Support for Medicare Beneficiaries?

For eligible veterans, V.A. benefits can be a way to cover any unpaid expenses not covered by Medicare. These services include:

  • Physical exams and other preventative care
  • Dental services
  • Long-term in-home care
  • Long-term nursing home residential care

What Does Medicaid Cover?

Medicaid covers low-income individuals and families, pregnant women, people with disabilities, and people receiving Supplemental Security Income (SSI). States are required to include coverage for:

  • Inpatient and outpatient hospital services
  • Physician services
  • Lab and X-ray services
  • Home health services

FAQs

For purposes of Medicare, you need legal authorization anytime you’re acting on behalf of a beneficiary. For example, you can’t enroll another person in Medicare, even your spouse, unless you have the power of attorney, health care proxy, or other authorization to make such decisions for the beneficiary. Adults can name a personal representative of their choosing, which would make that person their health care power of attorney and their personal representative.
It is possible to change a Medicare plan. The best time to make the switch is during the Annual Election Period (also known as Open Enrollment Period), which is open from October 15 to December 7 every year. Once you make the necessary changes, the new coverage will begin the following year on January
Some people may qualify for “dual eligibility,” meaning they are qualified for Medicare and Medicaid. Under both insurances, most of your healthcare costs will likely be covered.