The first post in this series outlined the basics of enrolling a care recipient in Medicare. The second post elaborated on the specifics of enrolling a recipient in Part D. Although those articles laid out most of the basic rules and guidelines to get started, some situations are more complicated than others—and that's where this post comes in. If any of the below scenarios sound like the situation you and your loved one are currently experiencing, read on to discover some possible solutions and next steps.
Is your family member disabled?
If your family member is disabled, it's possible that they may be on Medicare and not even know it. If they left the workforce on disability, and have been receiving Social Security Disability Income beginning at any age, they are automatically enrolled in Medicare after 24 months on disability. If you believe this is the case, but can't find a Medicare card in the person's wallet (or a card from a Medicare managed-care organization), you can try calling Medicare's toll-free number at 1-800-MEDICARE to see if they are enrolled. You can also ask to have a replacement card sent. Make sure the loved one you are calling on behalf of is present, because Medicare will not disclose personal information without their permission.
Is your loved one still working or covered by a spouse's work insurance?
If your loved one is still covered by insurance from active employment (their own or a spouse's), they may have Medicare Part A, but not Part B. Many people who are still covered by their employer when they turn 65 enroll in Part A because it is free for most people (unlike Part B, which generally requires a monthly premium). Call 1-800-MEDICARE and describe the person's current situation. The representative can help you find out whether they are already enrolled in any of the parts of Medicare and if they now need to enroll in part B as well. This call can also help you determine if your loved one may need prescription drug coverage through a Part C or Part D plan. Drug coverage through Medicare is optional, but highly recommended for anyone who does not already have drug coverage through an employer or other approved organization.
Is your loved one a veteran?
Sometimes veterans with limited incomes say they don't want to enroll in Medicare; instead, they want to receive all their care from the Veterans' Administration. This is certainly their right, but before making that decision, it is wise to encourage them to understand the implications. If their income and asset levels are low, they may not need to pay the monthly premiums for Part B, which gives them the option of benefiting from both systems. Also, check their status with the VA. If they have a documented service-connected disability, they will be far more likely to have access to a wide variety of treatment options. A local veterans' agent can see if your relative might qualify for a service-connected disability like PTSD or exposure to Agent Orange.
Do you need family caregiver support?
If you are looking for advice about caregiving, try contacting your local Area Agency on Aging so they can refer you to their Family Caregiver Support Program. This is a free, federally funded program which operates across the US and serves anyone over the age of 18 who is taking care of someone over the age of 60 (if the individual has dementia, the age limit is reduced). It also helps anyone 60 and older who has caregiving responsibility for another individual, including grandchildren or disabled adult children. The FCSP staff has a wealth of knowledge and experience. If you think you're the only one who has ever had siblings taking opposing views on "what to do about Dad," chances are that the FCSP people have heard dozens of stories that mirror yours, and they can provide invaluable guidance and perspective.
Find free professional help
Finally, if you're not sure what next steps make the most sense for you, consider seeking free, one-on-one professional counseling. The non-profit National Council on Aging created a tool called the Medicare Mini-Check that can help you compare plans and access free professional advice from a licensed Medicare advisor. Another great resource is the State Health Assistance Insurance Program (SHIP). They provide free, federally funded Medicare advice through volunteer counselors. You can find your local SHIP by visiting their website or by calling their toll-free hotline at 1-877-839-2675.
Medicare can be complicated—but it doesn't have to be!
Above all, don't expect to be an expert in these matters—and don't hesitate to reach out for the guidance you need. Experienced insurance counselors have seen physicians, attorneys and financial planners who have panicked when beginning to think about Medicare. It takes a village to insure an elder!