Some Medicare beneficiaries are quite comfortable and confident when it comes to selecting the coverage that will best fit their needs. But others may prefer to get help.
You might need help with the process as soon as you become eligible for Medicare. Or you might find that the annual enrollment period – during which you can make changes to your Medicare Part D or Medicare Advantage coverage – becomes more challenging over time, as you get older or need more extensive medical care.
Here’s what you need to know if you plan to seek help:
What information does an agent or broker need to help me enroll in Medicare?
An agent or broker can help you with the process of selecting a plan and completing the enrollment. In order to best assist you, they will need to know the names and dosages of any medications you take, as well as your preferred pharmacies, so that they can narrow down the options based on how your medications will be covered. (Out-of-pocket costs for specific medications will vary considerably from one plan to another and from one pharmacy to another).
And if you’re considering Medicare Advantage plans, the agent will also need to know the names of your doctors, in order to find plans that have those doctors in their provider networks.
Can a friend or family member help me sign up for Medicare?
You always have the right to have a trusted friend or family member present while you’re discussing your health coverage needs with Medicare, your state’s Medicare SHIP, or with an agent or broker.
How can I authorize Medicare to discuss my coverage with someone else?
If you want Medicare to be able to directly share your personal health information with someone else, there’s an authorization form that you’ll need to complete. Once you have it on file with Medicare, you can add names to it or update it through your MyMedicare.gov account.
Can someone help me sign up for Medicare if I'm incapacitated?
If you’re incapacitated and unable to participate in your own plan selection process, someone else can act on your behalf as long as you’ve created a power of attorney (POA) and named that person as your legal representative. In order to access your Medicare account information, your named POA representative will also need to be named on the Medicare disclosure authorization form.
Can a friend or family member talk about my coverage with a private Medicare insurance company?
If you’re enrolled in a private Medicare plan (a Part D plan, a Medicare Advantage plan, or a Medigap plan), the insurance company will have its own disclosure authorization form that you’ll need to complete so that they can discuss your coverage with a loved one.
Even if you were initially happy to select a Medicare plan on your own, it’s important to think about how this might change over time. Having a power of attorney in place will be vital if you ever become incapacitated and need a loved one to make decisions on your behalf.
The disclosure authorization forms for Medicare and private Medicare plans can be completed by the person you’ve named in your power of attorney, but completing these forms ahead of time will help to minimize roadblocks if someone needs to step in on your behalf.
Who can help me if I have a problem with my Medicare coverage?
If you have questions about your Medicare plan or problems with your coverage, you can contact various entities depending on the situation:
- If the coverage is Medicare Advantage, Medicare Part D, or Medigap, you can call the insurer directly, using the contact number on your plan ID card. If they aren’t able to sort out the issue, you can also call 1-800-MEDICARE to discuss the situation.
- If you used a broker to enroll in Medicare Advantage, Medicare Part D, and/or Medigap, you can contact the broker if you have problems or questions about your coverage.
- If the coverage is Original Medicare (Medicare Part A or Part B), you can call 1-800-MEDICARE.
- If you have general questions about any aspects of Medicare, you can reach out to the Medicare State Health Insurance Assistance Program (SHIP) in your state.
- If you misplaced your Annual Notice of Change letter (which arrives each year in September from your Medicare Advantage or Part D plan), you should call your Medicare Advantage or Part D insurer to get details on how your coverage is changing for the coming year.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.
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