As your parents get older, their health insurance is something very important that should be established and secure. Elderly parents may have more hospital costs, accidents, surgeries, etc., all of which you want to be prepared for. It’s important to note that once parents are over 65 and start retiring from work, their health insurance and benefits may change. It’s essential that you are aware of this change and talk with them about their options. This can be an intimidating or uncomfortable conversation, but it is better to have a plan that both you and your parents are aware of, then to be in a situation where they cannot afford the help they need. Below is some information about different healthcare plans and how you can find out more information for yourself.

What is medicare?

Medicare is a healthcare plan for individuals over 65 years old. They must be 65 and older to qualify for medicare, and it is a government program to insure older adults, especially those who are retired. Medicare covers a variety of treatments. Medicare, Part A provides coverage for inpatient hospital care hospice, etc.

Medicare, Part B provides coverage for physician office visits, prevent care check ups, and appointments similar to those. Neither Medicare, Part A or B covers prescription drugs, which is known as Part D.

Medicare Part D may be covered with Medicare advantage plans, which also provide coverage for other health services. These health services include dental, vision, and hearing, which are vital services for your parents to have access to as they age and parts of their body start to decline in function.

What are your parents’ options for healthcare?

If your parents are already 65, or approaching 65, then it’s important to discuss with them what are they doing for healthcare, and is it going to be enough for them moving forward. If your parent has failing health, or is getting ready to retire from a job that provides them with healthcare benefits, then it is definitely important to start discussing these options with them and what it is that they would like to do.

Medicare, Medicare Advantage, and Medicare Supplement (Medigap) are all plans that your parents qualify for at 65. They are also eligible for Medicare if they have been a citizen for five years and paid ten years of social security taxes. Your parents do not need to enroll in Medicare if they are still employed by a company with 20 or more employees from whom they are receiving coverage until they retire. If your parents work at a job with less than 20 employees, then they need to enroll in Medicare A and B with Medicare being the primary payer. Your parents are automatically enrolled once they start receiving social security payments. Even if your parent doesn’t sign up for social security, then they should sign up for Medicare when they are 65 to avoid late penalties (unless your parent is insured by a company or their spouse).

Obamacare is an option for your parents where they can buy insurance from their state exchange if they aren’t eligible for medicare. But, if they are eligible for Medicare, and instead decide to buy insurance from the exchange, then they won’t receive any tax credits. They cannot sign up for both Medicare and the exchange, meaning they must choose one.

Private Health insurance is always an option, however, most agents will probably direct them to a Medicare or Medicare Advantage plan anyways.

Employer or Retiree Insurance is an option for your parent if they are still working or have received health benefits from their retirement plan. When your parent retires and signs up during the special enrollment period, they will not be charged a late penalty. If your parents have retiree insurance, then they will have to enroll in Medicare Part A and B because Medicare will be the primary payer.

What are the costs of healthcare?

There is not an exact figure on how much your parents’ healthcare will cost. The important thing is to talk with the insurance companies to find out information about out-of-pocket costs. Here are somethings to consider when deciding which option is the best financially:

• How much are the monthly premiums? It’s important to see how much your parents will have to come out of pocket each month. It may be tempting to go for a cheaper option, but if it means that your parents will have to pay more for short-term significant health episodes, then it may not be worth it.
• What is the amount of money that your parents must spend before their insurance payment plan kicks in? You will want to know what the deductibles are for each plan to factor that into the monthly costs to see which is the best option.
• Will your parents be responsible for any percentage of the cost of their health services? Make sure you find out about your parents’ coinsurance to see which option best suits them.
• Will your parents have to pay a flat fee for any of their health services or treatments? Copayment is an important factor in the cost of your parents’ healthcare costs as well.

When deciding on the best option, make sure to add all of these costs together and see which will provide great coverage in the care of an incident, but won’t put a huge dent in your parents’ monthly budget.

Who can your parents go see?

Participating in Medicare does put limits on who your parents can go see for providers. If your parents are on the original Medicare or Medigap policy, then they can only go see a participating Medicare provider. If your parent already has providers, check to see if they accept Medicare, or your parents may not be able to continue seeing them. If your parents decide to go with Medicare Advantage plans, then health maintenance organizations (HMOs) or preferred provider organizations (PPOs) are going to be their options. With HMO, your parents would have to choose providers who are within the network. With PPO, your parents can continue seeing their current provider. Networks can change at a moment’s notice, so you should understand what the financial liabilities are of going out of the network.

How can you find out more information about healthcare coverage for your parents?

If you would like to find out more information on your parents options, you can visit a few sources. One of those is Medicare Rights Center which is an independent, state-specific hub of information on healthcare coverage. They have a health hotline, as well as a MI counselor that can walk you through the qualifications.

The National Council on Aging provides a Benefits and Checkup on its website. It is a fast, free confidential screening tool that can help determine if your parents meet the eligibility requirements for about 1000 federally sponsored programs. It also has detailed information on how to apply for programs.

The State Health Insurance Assistance Program (SHIP) is a national program that offers one-on-one counseling and assistance. Every state can provide over the phone or in person free counseling on a wide range of medicare issues. Give them a call if you have trouble choosing which health plan or have issues regarding billing, problem resolution, etc.

Sources:

https://www.pbs.org/wgbh/caringforyourparents/handbook/insurance/understandinginsurance.html