Enrolling a loved one in Medicare: Extenuating circumstances

In parts one and two of our series, we’ve covered the basics of enrolling a loved one in Medicare. We’ve examined the basic eligibility requirements. We’ve discussed Original Medicare Part A and Part B coverage versus Medicare Advantage (or Part C) plans. We’ve also looked at Medicare’s Part D prescription drug plan, including the incentives for enrolling early as well as re-examining your loved one’s coverage during the annual open enrollment period.

All of this information should give you a good head start on the research required to make an informed Medicare decision on behalf of your loved one. But what if your loved one has some extenuating circumstances? We’ll talk about a few example cases below.

If a Veteran

If your loved one is a military veteran, they may already be receiving healthcare from the Veteran’s Administration. In many cases, your loved one should still enroll in Medicare even if they’re receiving VA care. It’s a particularly good idea if your loved one has low income and few assets. In that case, they likely will not need to pay Medicare’s Part B premiums, allowing them to take advantage of Medicare benefits as well as VA benefits at no extra cost. You should also consult with the VA if your loved one has a service-connected disability such as PTSD. If they do, this may entitle them to further benefits.

If employed

If your loved one is still employed or is covered by their spouse’s employer health insurance, they might already be enrolled in Medicare Part A. If not, they should go ahead and enroll. Unlike Part B that requires a monthly premium, Part A is free. You should consult with both the employer health care administrator as well as a Medicare representative to determine the best course of action for your loved one to take in terms of Medicare enrollment. You can speak with a Medicare rep directly either at your local office or by calling 1-800-633-4227.

If disabled

If your loved one is disabled, they may unknowingly be enrolled in Medicare already. If your loved one left work because of a disability, or if they have been receiving Social Security disability payments (regardless of their age), they are automatically enrolled in Medicare after 24 months on disability benefits. You should ask your loved one if they have received a Medicare membership card by mail. If not, or if they cannot remember, you can call the above Medicare phone number to ask for another card. Keep in mind that your loved one will need to be available while you make the call, since Medicare will not take action without their consent.

Additional resources

If you have further questions about your role as a caregiver, or you need advice on how best to manage your loved one’s care moving forward, you can contact the federal government’s Administration on Aging. This program is designed to help anyone over the age of 18 who is caring for someone over the age of 60. You can also contact your local State Health Assistance Insurance Program (SHIP). SHIP is a federally funded program staffed by knowledgeable volunteers who offer counseling relating to Medicare decisions and caregiving.

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