It often starts with a pile of mail on the kitchen table. Glossy postcards promise extra benefits, envelopes are stamped “Important Plan Information,” and the phone keeps ringing with callers who say they can “lower your costs today.” An older parent sorts through it all and finally says, “I’ll just keep what I have.”
Sometimes keeping the same plan is exactly right. But plans can change from one year to the next, and so can a person’s health, medicines and doctors. Medicare’s annual Open Enrollment Period runs from October 15 to December 7 each year, and any change made during that window generally takes effect on January 1. For families, these weeks before the holidays are a valuable chance to sit down together and take a careful look.
Consider a hypothetical retired bus driver in Silver Spring who takes several daily prescriptions and recently started seeing a new heart specialist. His daughter helps him with bills, but neither of them has looked at his drug coverage in two years. A one-hour review could help them learn whether his medicines are still covered, whether his specialist is in his plan’s network and whether another option fits his needs better. This guide explains how adult children and other relatives can help without taking over, and where to find free, unbiased help.
What Open Enrollment Is, and Why It Matters
Medicare has several parts, and many people combine them in different ways. Some people use Original Medicare, often with a separate Part D prescription drug plan and sometimes a supplemental policy. Others choose a Medicare Advantage plan, offered by private companies approved by Medicare, which often bundles hospital, medical and frequently drug coverage together.
During Open Enrollment, people with Medicare can generally switch between Original Medicare and Medicare Advantage, change from one Medicare Advantage plan to another, or join, drop or switch a Part D drug plan. If nothing is done, many people simply stay in their current coverage for the next year.
That default can be fine, but it is worth checking. A plan’s monthly premium, deductible, list of covered drugs and network of doctors and pharmacies can change from year to year. A plan that fit well last year may fit less well now. Reviewing does not mean you must switch. It means you are choosing on purpose.
Start With a Respectful Conversation
Many older adults in our community have managed their own affairs for decades and take pride in their independence. A review goes best when it feels like teamwork, not a takeover. You might open with something like, “I know the plans change every year. Would you like me to sit with you and look at yours?”
Let your parent lead. Ask what matters most to them. For some people, the top priority is keeping a trusted doctor. For others, it is a low monthly cost, coverage when traveling to see family, or access to a particular hospital. Listening first helps you focus the review on what your parent actually values.
Respect privacy, too. Your parent decides how much you see and who else is involved. If siblings want to weigh in, agree on one or two people to do the hands-on work and share a short summary with everyone else. This reduces confusion and keeps the decision in your parent’s hands.
Gather the Right Papers Before You Compare
A review moves faster when you have the key information in one place. Before you sit down, gather:
- Your parent’s red, white and blue Medicare card and any plan membership cards
- The “Annual Notice of Change” letter from their current plan, if they have one
- A complete list of current prescriptions, with dose and how often each is taken
- The names of doctors, specialists, hospitals and pharmacies they use
- Any recent bills or statements that showed surprising costs
- Notes on planned care for next year, such as a surgery or new therapy
The Annual Notice of Change is especially useful. Plans send it to members ahead of Open Enrollment, and it explains what will be different next year. Read it together and circle anything that affects your parent’s medicines or doctors.
Using the Medicare Plan Finder Together
Medicare offers an online comparison tool called the Medicare Plan Finder on Medicare.gov. You can enter your parent’s ZIP code, prescriptions and preferred pharmacies, then compare the plans available in that area. Logging in to a Medicare account can make the drug list easier to save and reuse.
As you compare, look beyond the monthly premium. A plan with a low premium may have higher costs at the pharmacy or the doctor’s office, and the opposite can also be true. Look at estimated yearly drug costs, deductibles, copayments and whether each doctor and pharmacy your parent relies on is included.
Take your time and write down what you find. A simple sheet with two or three plan names across the top and rows for premium, drug costs, doctors and pharmacies can make the differences much clearer. If the tool feels confusing, that is common. Free help is available, as described below.
Pay special attention to medicines. A drug that was covered last year may move to a different cost tier, need prior approval from the plan or drop off the list entirely. If one of your parent’s prescriptions is not covered by a plan you are considering, write that down and ask their doctor or pharmacist whether a covered alternative might work. Only the prescriber can decide whether a change is appropriate, so treat this as a question to raise, not a decision to make on your own.
If your parent lives part of the year with relatives in another state or travels often, ask how each plan handles care away from home. Networks can be local, and that detail matters for families spread across the DMV, the South and beyond.
Free, Unbiased Help Is Available
Every state has a State Health Insurance Assistance Program, often called SHIP. These programs offer one-on-one counseling for people with Medicare and their families from counselors who are not selling any particular plan. In the DMV, Maryland, Virginia and the District each have their own program, and you can find the local office through the SHIP national directory or by calling 1-800-MEDICARE.
A SHIP counselor can help explain options, review a drug list and talk through questions about costs. Many families find it reassuring to hear from someone whose job is to help, not to sell.
If money is tight, ask about programs that help with costs. Medicare’s Extra Help program can lower prescription drug costs for people with limited income and resources, and Social Security handles applications. States also run Medicare Savings Programs that may help with premiums and other costs. Eligibility rules vary, so a counselor or the agency itself can tell you whether your parent may qualify.
Watch Out for Pressure and Scams
Open Enrollment season brings a flood of advertising and phone calls, and some of them are not honest. A common warning sign is pressure: a caller who insists your parent must decide today, offers free gifts in exchange for personal information or says Medicare itself is calling to sign them up.
Encourage your parent to never give out their Medicare number, Social Security number or bank information to an unexpected caller. If someone calls claiming to be from Medicare or a plan, it is safer to hang up and call the official number printed on the card or on Medicare.gov. A family rule, such as “We don’t make health decisions on the first phone call,” can protect everyone.
It also helps to remember that agents and brokers may be paid by the plans they sell. Some are helpful and knowledgeable, but their advice may not cover every option. Comparing their suggestions with the Plan Finder or a SHIP counselor is a sensible double-check.
After the Decision
Once your parent decides, keep a record. Write down the plan name, the date of any change and any confirmation number. Save letters from the new or current plan in one folder, and make sure new membership cards arrive before January.
If your parent switches plans, check early in the new year that prescriptions fill smoothly at the pharmacy and that their doctors recognize the new coverage. Small problems are easier to fix in January than in a crisis.
Finally, put a reminder on the calendar for next fall. Making the review an annual family tradition, perhaps over a meal in October, turns a stressful task into a routine act of care. This article offers general education only. For decisions about your parent’s coverage, speak with a SHIP counselor, Medicare directly or another qualified professional.
One Next Step: Before the end of this week, sit with your parent for thirty minutes to write down every current prescription and every doctor and pharmacy they use, then use that list to compare plans or to prepare for a call with your local SHIP counselor before December 7.
Akukulu Family encourages adult children, grandchildren and caregivers to treat Medicare Open Enrollment as a season of respect and partnership with our elders. A little time spent together now can protect their health, their budget and their peace of mind in the year ahead.
Source for verification: Medicare.gov, Medicare Plan Finder: https://www.medicare.gov/plan-compare/
