Helping Your Parents Through Medicare Open Enrollment (Oct 15–Dec 7)

Medicare Open Enrollment runs from October 15 to December 7 every year, and any changes take effect January 1. If your parents are on Medicare, this is when they can switch plans, and when a short review can save them money or headaches. Your job isn’t to make the decision for them. It’s to help them gather the right information, use the free official tools and avoid the sales pressure that ramps up every fall.

How to help without taking over

If you’re in your 30s and helping a parent, you might also be managing your own insurance, kids and work. That’s the sandwich generation, and our sandwich generation insurance guide covers the bigger picture. For Medicare, a few ground rules make this go smoother:

• Ask first. “Would it help if we looked at your Medicare plan together this year?” works better than “I need to fix your Medicare.”
• Let them lead on priorities. They know which doctors they trust, which pharmacy they like and how much they can comfortably pay each month.
• Do the legwork, not the deciding. Gather documents, run comparisons, make calls if they want you to. Leave the final choice to them unless they’ve asked you to take over or are no longer able to decide.
• Bring in siblings early. If more than one of you is involved, agree on who’s handling what so your parent doesn’t get conflicting advice.

What your parent can change during Open Enrollment

From October 15 to December 7, people on Medicare can generally:

• Switch from Original Medicare to a Medicare Advantage plan, or the reverse
• Switch from one Medicare Advantage plan to another
• Join, drop or switch a Part D prescription drug plan

If they’re already in a Medicare Advantage plan, there’s a second chance: the Medicare Advantage Open Enrollment Period, January 1 to March 31. During that window they can switch to a different Medicare Advantage plan or go back to Original Medicare, one time.

What to review this year

1. The Annual Notice of Change

If your parent has a Medicare Advantage or Part D plan, the plan mails an Annual Notice of Change (ANOC), usually by the end of September. It lists what’s changing next year: premiums, deductibles, copays, the drug list and the provider network. Find it first. If they can’t, call the plan and ask for another copy, or look for it in their online member account.

2. Their drug list vs. the plan’s formulary

Write down every prescription with the exact name, dose and how often they take it. Then check each one against the plan’s formulary (its list of covered drugs) for next year. Look for drugs that were dropped, moved to a higher-cost tier or now need prior authorization or step therapy.

3. Their doctors and hospitals

If they have a Medicare Advantage plan, confirm that their primary care doctor, specialists and preferred hospital are in the network next year. Provider directories aren’t always current, so for the doctors that matter most, call the office and ask, “Will you be in network with [plan name] next year?”

4. Total cost, not just the premium

A $0-premium plan isn’t free if it has high copays or doesn’t cover a key drug well. Estimate total yearly cost: monthly premiums for 12 months, plus expected drug costs, plus likely copays for regular visits. For a Medicare Advantage plan, also note the plan’s out-of-pocket maximum, which caps what your parent pays for covered medical care in a year.

Use the free official tools

Medicare.gov Plan Finder

The Medicare Plan Finder is the official comparison tool. Enter your parent’s ZIP code, drugs and pharmacy, and it estimates yearly costs for the Part D and Medicare Advantage plans available to them. It works better if your parent logs in to their Medicare.gov account, because it can pull in their current drugs and plan. Sit down together and do this in one session.

SHIP: free, unbiased counseling

Every state has a State Health Insurance Assistance Program (SHIP). SHIP counselors are trained to give free, one-on-one Medicare help, and they don’t sell insurance. Find your parent’s local program at shiphelp.org. Appointments fill up during open enrollment, so book early.

Avoid scams and high-pressure sales

Open enrollment is peak season for Medicare marketing, and some of it is aggressive or fraudulent. Go over these red flags with your parent before the calls start:

• Someone calls claiming to be “from Medicare.” Medicare doesn’t cold-call people to sell plans. Hang up and call 1-800-MEDICARE directly if there’s any doubt.
• A caller asks for a Medicare number, Social Security number or bank details. Your parent shouldn’t give these to anyone who contacted them unexpectedly.
• Pressure to decide today. Legitimate options will still be there tomorrow. Open enrollment lasts until December 7.
• Promises of free gifts, cash or “extra benefits you’re missing out on.” These pitches are often designed to get people to switch plans without reading the details.
• TV ads urging viewers to call a number. Those usually connect to a sales agent or call center, not to Medicare.

If your parent shared information with a suspicious caller, report it to 1-800-MEDICARE and keep an eye on their Medicare Summary Notices for services they didn’t receive.

Paperwork and permissions

Because of privacy rules, Medicare and plans won’t simply talk to you about your parent’s account. Set up permissions before you need them.

1. 1-800-MEDICARE authorization. Form CMS-10106, the “Authorization to Disclose Personal Health Information,” lets 1-800-MEDICARE share your parent’s information with you. Your parent can submit it through their Medicare.gov account or by mail, and can choose an end date or revoke it later. Get the current form from CMS.gov.
2. Each plan’s own form. Medicare Advantage, Part D and Medigap insurers usually have their own authorization forms. Call the member services number on your parent’s plan card and ask for one.
3. Longer-term documents. A healthcare power of attorney or similar documents can matter if your parent becomes unable to make decisions. These are state-specific legal documents, so talk with an elder law attorney about them.
4. A shared folder. Keep copies of Medicare cards, plan cards, the ANOC, medication lists and doctors’ contact info in one place (paper or a secure shared drive) that the right people can reach.

For the broader picture, including long-term care, see our guides to insurance for aging parents and long-term care insurance.

This is general education, not personal advice. For decisions about your parent’s coverage, use SHIP counseling, 1-800-MEDICARE or a licensed professional you trust.

Frequently asked questions