Helping a Parent with Medicare – A Practical Guide for Adult Kids

If you're helping Mom or Dad with Medicare, you're not alone. A lot of folks I talk to are calling for a parent.

Here's the first thing to know. Medicare, Social Security, and your parent's plan generally won't talk to you about your parent's details without permission. So step one isn't comparing plans. It's getting set up to help.

Let's go through it in order.

The mental model: permission, paperwork, then the yearly check

Helping a parent with Medicare comes down to three jobs:

1. Permission. Get the right to talk to Medicare and their plan.
2. Paperwork. Gather everything in one place.
3. The yearly check. Review their coverage every fall.

Do the first two once. Do the third every year.

The analogy: being the family's "spare key" holder

Think about the neighbor who holds your spare key. They can't just walk in whenever. You gave them permission ahead of time, so when something comes up, they can help fast.

That's what you're setting up here. Permission in advance, so when a bill looks wrong or a prescription gets denied, you can pick up the phone and help right away.

Step 1: Get permission to talk to Medicare

Medicare has a form for this: CMS-10106, Authorization to Disclose Personal Health Information. It gives Medicare permission to talk to someone your parent chooses about their claims and health records.

There are two ways to do it:

• Fill out the form and mail it to the address on the form.
• Do it online. With your parent's okay, log into their secure Medicare account. Go to the account settings, find "My representatives," and add yourself.

Once that's set, you can call 1-800-MEDICARE on their behalf. Help there is available 24 hours a day, 7 days a week, except some federal holidays.

Step 2: Ask the plan, too

If your parent has a Medicare Advantage plan, a Part D drug plan, or a Medicare Supplement, that company handles its own records. Medicare's permission doesn't always carry over.

Call the number on their plan card and ask, "What do you need so I can talk to you for my parent?" Many have their own form.

Step 3: Know the difference between helping and legal authority

Permission to talk about your parent's Medicare isn't the same as legal authority to make decisions for them.

• For Social Security benefits, if your parent can't manage their payments, Social Security has a Representative Payee program. Call Social Security at 1-800-772-1213 to ask about it.
• Social Security notes that family members giving general help don't need to be formally appointed as representatives. Think filling out forms or driving to an office.
• For health care and money decisions, documents like a power of attorney are a legal matter. Talk to an attorney about those. That's outside our lane.

Step 4: Build the "Medicare folder"

Get everything in one place. A real folder, a binder, or a shared note works. Here's what I'd put in it:

• [ ] Their Medicare card (a copy is fine)
• [ ] Plan cards: supplement, Medicare Advantage, Part D
• [ ] A current drug list with doses and how often they fill each one
• [ ] Doctor names and phone numbers, including specialists
• [ ] Their pharmacy
• [ ] The plan's Annual Notice of Change each fall
• [ ] Any letters from Social Security or Medicare
• [ ] Logins for their Medicare and Social Security accounts, stored safely

When something goes wrong at 4:45 on a Friday, you'll be glad it's all in one spot.

Step 5: Do the yearly review each fall

Medicare Open Enrollment runs October 15 to December 7. That's your yearly check.

What I'd look at with your parent:

• Did their drugs change this year? Check them against next year's drug list.
• Are their doctors still in network, if they're in a Medicare Advantage plan?
• Did the plan's Annual Notice of Change flag anything big? It usually arrives in September.
• Is their pharmacy still a good fit?
• Has their income changed? They might qualify for Extra Help or a Medicare Savings Program.

My full Medicare Open Enrollment checklist walks through it step by step. And our Medicare plan finder can estimate drug costs for plans in their county.

Step 6: Keep your parent in the driver's seat

This one isn't a form. It's respect.

Even when you're doing the legwork, it's their coverage and their health. Ask what matters to them. A favorite doctor. A pharmacy close to home. Not wanting a lot of phone calls. Build around that.

If you're helping from far away

Plenty of families have one kid in Springfield and another in St. Louis or Kansas City. Medicare's tools work from anywhere. Set up account access, keep the folder digital, and pick one family member to be the main contact. It saves confusion.

Free, unbiased help is available too

Every state has a State Health Insurance Assistance Program (SHIP). Medicare notes SHIPs aren't connected to any insurance company. They offer free counseling.

• Missouri SHIP: 1-800-390-3330
• Kansas SHICK: 1-800-860-5260

Things I'd do (and never do)

1. I'd get the CMS-10106 permission set up now, before there's a problem.
2. I'd keep one up-to-date drug list and update it after every doctor visit.
3. I'd put October 15 on the calendar for the yearly review.
4. I'd never change my parent's plan without them understanding why.
5. I'd never give out my parent's Medicare number to someone who calls out of the blue.

Want us to walk through it with your family?

We're happy to meet with you and your parent together, in person or by phone. We'll look at their drugs, doctors, and budget and lay out the options clearly.

Call (417) 633-7200, or stop by our Springfield office at 3616 S Campbell Ave. Family in the St. Louis area? Our Wildwood office is close by.

You don't have to figure this out alone.

— Matt

Frequently asked questions

How do I get permission to talk to Medicare for my parent?

Your parent can complete Form CMS-10106 and mail it in, or add you as a representative in their secure Medicare account. Then you can call 1-800-MEDICARE for them.

Does Medicare permission let me talk to my parent's plan?

Not always. Medicare Advantage, Part D, and supplement companies keep their own records. Call the plan and ask what they need.

Is Form CMS-10106 the same as power of attorney?

No. It gives Medicare permission to share your parent's information with you. Legal authority to make decisions is a separate legal matter. Talk to an attorney.

What should I gather to help my parent with Medicare?

Their Medicare card, plan cards, a current drug list, doctor and pharmacy info, the plan's Annual Notice of Change, and any letters from Medicare or Social Security.

When should we review my parent's Medicare plan?

Every fall during Open Enrollment, October 15 to December 7. Changes start January 1.