How to help a loved one enroll in Medicare or Medicare Advantage

If you’re taking care of a parent or grandparent — or just want to lend a hand during the Annual Enrollment or Open Enrollment periods — understanding Medicare and Medicare Advantage options is key to finding them their best plan.

When you know the plan options, you can help your loved one find the best coverage.

Understand their medical needs and current coverage

Before you can help someone choose the right Medicare or Medicare Advantage plan, you need to know their medical needs and their budget. Look at all plan costs and compare them to a set budget. Then you can make sure they can afford whichever plan option they choose.

You’ll also want to gather a list of your loved one’s current prescriptions to check that they’re covered by any new health plan you’re both considering. The same goes for any doctors they are seeing. If they’d like to stay with the same doctors, make sure those doctors are a part of a plan’s network before switching.

Medicare vs. Medicare Advantage plans

Knowing the difference between Medicare and Medicare Advantage is an important part of finding the right plan for your loved one.

Medicare, also called Original Medicare, is made up of Part A and Part B plans. It’s a government-issued health insurance plan that covers medical costs for people 65 and older.

Medicare Advantage is a private insurance plan that offers more benefits than Original Medicare. These health plans provide coverage for services that Medicare does not, in addition to covering hospitalization and medical care.

Here’s an overview of what each part of Medicare covers:

• Part A helps cover the big things, like hospitalizations and skilled nursing care.
• Part B helps cover routine care, like doctor visits and preventive care.
• Part C (also called Medicare Advantage or MA) includes Part A and Part B benefits and:
  • Often has no or low monthly premiums
  • Often includes prescription drug benefits (Part D)
  • Limits your out-of-pocket expenses
  • Can include extra benefits like dental, vision, hearing and wellness
• Part D can also stand alone as separate prescription drug coverage.
  
  

Making the most of Annual and Open Enrollment Periods

If you’re ready to enroll your loved one in a Medicare or Medicare Advantage plan, there are two main times of year when you can enroll them: 

• Annual Enrollment Period (AEP), which takes place from Oct. 15 through Dec. 7
• Open Enrollment Period (OEP), which takes place from Jan. 1 through March 31

During OEP, your parent can switch to another MA plan or switch back to Original Medicare. However, remember that they can't leave an Original Medicare to join a Medicare Advantage Plan during OEP. That can only be done during AEP.

Outside of these two time frames, they may qualify for a Special Enrollment Period (SEP) if they experience a qualifying event, such as moving out of their current plan’s coverage area.

Need help finding a plan for your parent or grandparent? Talk with one of our Medicare advisors. Call us today at 800-482-8163 (TTY: 711).

Next steps:

Learn about the difference between Medicare and Medicare Advantage
Interested in Medicare Advantage? Here’s how to choose a plan
Learn about Geisinger Gold Medicare Advantage

Geisinger Gold Medicare Advantage HMO, PPO, and HMO SNP plans are offered by Geisinger Health Plan/Geisinger Indemnity Insurance Company, health plans with a Medicare contract. Continued enrollment in Geisinger Gold depends on annual contract renewal.

Y0032_23269_1_M Accepted 10/1/23