A Family and Caregiving Guide to Supporting Aging Parents With Medicare

Helping aging parents with Medicare can mean anything from comparing plans and organizing paperwork to attending appointments or making phone calls together. The most useful role for a family member or caregiver is often helping your parent understand their options, stay organized, and make informed decisions based on their healthcare needs and preferences.

You don’t have to become a Medicare expert. But knowing a few key rules and how to get permission to help when necessary can make navigating healthcare and Medicare much easier for your family.

 

 

Start the Medicare Conversation Early

Talk about Medicare before an enrollment deadline, health crisis, or unexpected coverage problem makes the conversation urgent.

Start by asking your parent what kind of help they would find useful. Some people may want you to research plans but make the final decision themselves. Others may want help tracking paperwork, attending appointments, or talking with Medicare and their insurance company.

Useful questions include:

• Which doctors and specialists do you want to continue seeing?
• What prescription medications do you take?
• Which pharmacies do you prefer?
• What healthcare expenses are most important to plan for?
• Do you travel or spend part of the year outside San Diego?
• What Medicare coverage do you currently have?
• Are there parts of Medicare you would like help understanding?

If your parent can make their own healthcare and insurance decisions, keep them at the center of the process.

 

Understand What Medicare Coverage Your Parent Has

Before comparing plans or calling an insurer, find out exactly what Medicare coverage your parent currently has.

They may have (2):

• Original Medicare: Medicare Part A and Part B, administered by the federal government.
• Medicare Advantage (Part C): A Medicare-approved private plan that provides Part A and Part B benefits as an alternative to Original Medicare. Many Medicare Advantage plans include Part D prescription drug coverage, but not all do.
• Part D: Prescription drug coverage provided through Medicare-approved private plans. It can be included in many Medicare Advantage plans or purchased as a standalone plan for people with Original Medicare.
• Medigap: Private Medicare Supplement Insurance that works with Original Medicare and helps pay certain out-of-pocket costs. It isn’t used with Medicare Advantage.

Don’t assume you know which coverage your parent has based on the insurance cards in their wallet. Look at their current plan documents or Medicare account together.

 

 

Get Permission Before Managing Medicare on a Parent’s Behalf

Being someone’s child or caregiver doesn’t automatically permit you to access all of their Medicare, insurance, or medical information.

If your parent wants you involved, find out what authorization each organization requires. An insurance plan, healthcare provider, and Medicare itself may have different authorization procedures.

For Medicare, beneficiaries can authorize Medicare to disclose personal health information to another person using Medicare’s authorization process (3).

Your parent’s Medicare Advantage, Part D, or Medigap insurer may have its own process for allowing an authorized representative or other designated person to discuss coverage.

Healthcare providers also have their own procedures for sharing protected health information and involving family members or caregivers.

The appropriate authorization depends on what you want to do for your parent. Permission to receive information isn’t necessarily the same as legal authority to make healthcare or financial decisions for someone else.

 

Keep Important Medicare and Healthcare Information Organized

A simple Medicare binder or secure digital folder can make it much easier to help your aging parents when questions arise.

Consider keeping:

• Medicare and insurance plan information
• Plan correspondence
• Annual Notice of Change (ANOC)
• Current medication list, including doses
• Pharmacy information
• Doctors and specialists
• Important medical conditions and allergies
• Upcoming appointments
• Medicare.gov account information stored securely
• Relevant authorization documents
• Notes from important Medicare or insurance conversations

Avoid copying or sharing sensitive identifiers unnecessarily. Store Medicare numbers, account credentials, and other personal information securely.

It can also help to keep a one-page medication and medical-information list that’s easy to update and access during an emergency.

 

Know the Medicare Enrollment Periods That Matter

You don’t need to memorize every Medicare deadline, but knowing the major enrollment periods can help your family avoid rushed decisions.

 

Initial Enrollment Period

For someone first becoming eligible around age 65, the Initial Enrollment Period generally lasts seven months: the three months before the month they turn 65, their birthday month, and the three months afterward.

Enrollment timing and effective dates can vary depending on the person’s circumstances.

 

Medicare Annual Enrollment Period

The Annual Enrollment Period (AEP) runs from October 15 through December 7 each year.

During the 2026 AEP, Medicare beneficiaries can make certain Medicare Advantage and Part D changes for 2027. Those elections generally take effect January 1, 2027.

 

Medicare Advantage Open Enrollment Period

From January 1 through March 31, people already enrolled in Medicare Advantage generally have a one-time opportunity to switch to another Medicare Advantage plan or return to Original Medicare. Someone returning to Original Medicare may also be able to join a standalone Part D plan.

This isn’t a general enrollment period for everyone with Medicare.

 

Special Enrollment Periods

Certain circumstances, such as moving or losing qualifying coverage, may create a Special Enrollment Period (4).

The rules and deadlines depend on the event.

 

Help Your Aging Parents Review Medicare Coverage Every Year

Even if your parent’s health hasn’t changed, their Medicare Advantage or Part D plan may change each year. Make an annual Medicare review part of your family’s fall routine.

For Medicare Advantage or Part D coverage, review the plan’s Annual Notice of Change and look for changes to:

• Premiums
• Deductibles
• Copays and coinsurance
• Prescription formulary
• Pharmacy network
• Doctors and other provider networks
• Prior authorization requirements
• Additional benefits
• Out-of-pocket limits, when applicable

A formulary is the list of prescription drugs a plan covers.

If your parent is considering a different plan, don’t compare premiums alone. Check their actual doctors, hospitals, medications, pharmacies, and expected healthcare use.

 

Help Prepare for Healthcare Appointments

If your parent wants you involved, attending a healthcare appointment in person or virtually can help them keep track of questions and instructions.

Before the appointment, make a short list of priorities. Depending on the visit, you might help your parent ask:

• What is this medication for, and how should it be taken?
• What side effects should we watch for?
• What follow-up care is needed?
• Who should we contact if symptoms change?
• Are there preventive services or screenings to discuss?
• What information should we bring to the next appointment?

Afterward, write down important instructions and update the medication list if something changed.

Remember that helping doesn’t have to mean speaking for your aging parents. Sometimes the most useful thing you can do is take notes while they talk with their healthcare provider.

 

Know the Difference Between Healthcare Needs and Insurance Questions

Caregiving becomes easier when you know who can answer which question.

• Contact your parent’s healthcare provider for questions about symptoms, diagnoses, medications, treatment, and appropriate medical care.
• Contact the insurance plan for questions about coverage, claims, provider networks, prior authorization, formularies, and plan benefits.
• Contact Medicare for official Medicare rules, enrollment information, and help understanding Medicare coverage.

A licensed Medicare insurance agent can explain plans they are authorized to offer and help with enrollment.

This distinction is especially useful when a caregiver needs a quick answer: the doctor’s office isn’t the right place to answer a plan-enrollment question, and an insurance agent isn’t the person to decide what medical treatment your parent needs.

 

Protect Your Aging Parents From Medicare and Social Security Scams

Older adults and their families should be cautious about unexpected Medicare or Social Security communications, but avoid rules such as “Medicare will never call” or “never give information over the phone,” which can be misleading.

Instead, teach your parent to stop and independently verify unexpected requests. Be cautious if someone:

• Creates urgency or threatens loss of benefits
• Unexpectedly asks for a Medicare or Social Security number
• Requests banking or payment information
• Promises “free” medical equipment in exchange for Medicare information
• Pressures your parent to switch plans immediately
• Asks for payment by gift card, cryptocurrency, or another unusual method
• Sends an unexpected link or attachment and asks them to log in

If you’re unsure whether a communication is legitimate, don’t use the phone number or link provided by the unexpected caller, text, or email. Contact the organization using a trusted number or website instead (5).

 

What If Your Aging Parents Don’t Want Help?

Respect their decision if they can manage their own healthcare and Medicare choices.

You can still let them know you’re available if they want help later. Rather than taking over, offer a specific kind of assistance:

• “Would you like me to compare these two plans with you?”
• “Do you want me to write down your questions for the doctor?”
• “Would it help if I organized these Medicare letters?”
• “Should we look up whether your doctors are in this plan together?”

Specific offers can be easier to accept than a broad suggestion that a parent needs someone else to manage their healthcare.

 

What If Your Parent Can No Longer Manage Medicare Decisions Independently?

If illness or cognitive changes make it difficult for your parent to manage healthcare or insurance decisions, being a caregiver or adult child doesn’t automatically give you legal authority to make those decisions.

The documents and authority you need depend on the situation and the decisions you must make. Families may need to review existing advance healthcare directives, powers of attorney, authorized-representative arrangements, or other legal documents.

It’s much easier to discuss these preferences and complete appropriate planning while a parent can still clearly express their wishes and participate in the process.

For questions about legal authority or estate planning, consider consulting an appropriately qualified attorney rather than relying on general Medicare guidance.

 

Where Can Caregivers Get Reliable Medicare Help?

Caregivers don’t have to rely on search results, social media posts, or unsolicited calls for Medicare information.

Medicare’s site provides official Medicare information and Medicare Plan Compare. You can also call 1-800-MEDICARE (1-800-633-4227).

California’s Health Insurance Counseling and Advocacy Program (HICAP) provides free, unbiased Medicare counseling to beneficiaries and their families.

For plan comparisons, Medicare’s official Plan Compare tool is also available.

 

Frequently Asked Questions About Helping Aging Parents With Medicare

Families often wonder how much they can and should do on a parent’s behalf.

 

Can I Call Medicare for My Aging Parents?

You can call Medicare for general information, but Medicare may need your parent’s permission before discussing their personal Medicare information with you.

If your parent wants you to have ongoing access to certain information, review Medicare’s authorization process.

 

Can I Speak to My Parent’s Medicare Advantage or Part D Plan?

Your parent’s insurance company may require permission before you can discuss protected account or coverage information.

Contact the plan together and ask what authorization it requires for a family member or caregiver.

 

Can I Choose a Medicare Plan for My Aging Parents?

If your parent can make their own decisions, the choice is theirs. You can help research plans, compare costs and networks, organize information, and ask questions.

Different legal considerations apply if someone has authority to act on another person’s behalf.

 

What Should I Review When Helping My Parent Compare Medicare Plans?

Start with the healthcare your parent actually uses: doctors, hospitals, prescriptions, and pharmacies.

Then compare premiums, deductibles, copays, coinsurance, provider networks, drug formularies, prior authorization requirements, applicable out-of-pocket limits, and additional benefits.

 

Does My Parent Have to Change Medicare Plans Every Year?

No. Reviewing coverage annually doesn’t mean changing it annually. The review ensures existing coverage will continue to meet your parent’s needs for the coming year.

 

When Can My Parent Change Medicare Plans?

The answer depends on their current coverage and circumstances.

October 15 through December 7 is Medicare’s Annual Enrollment Period, but other opportunities include the Medicare Advantage Open Enrollment Period and qualifying Special Enrollment Periods. Medigap has separate federal and state rules.

 

Supporting Your Aging Parents Without Taking Over

Helping aging parents navigate Medicare is less about knowing every Medicare rule and more about knowing what matters to them, where their information is, and where to get reliable answers.

Start conversations early, understand their current coverage, get appropriate permission before acting on their behalf, organize important information, review coverage annually, and keep your parent involved in decisions whenever possible.

Scripps Affiliated Medical Groups works with Caress Insurance Agency, LLC to help San Diego County residents understand Medicare insurance options. Visit our Medicare page to learn more and get in touch.

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