Did Mom’s Medicare Advantage plan pull a disappearing act, taking her favorite doctor with it? Open Enrollment starts October 15, and it’s her chance to make her coverage reappear before 2027.
Source: This America Life
ICYMI
💼 The National Alliance for Caregiving was awarded $2.5 million to help employers identify and support caregivers during open enrollment.
🏈 Mike Ditka, the Hall of Fame tight end who coached the Bears to their only Super Bowl title, died this week at 86. Off the field, Da Coach spent decades supporting Misericordia, a Chicago home for people with developmental and physical disabilities.
🏡 A new A Place for Mom survey found 54% of older adults think senior living can meet practical needs like safety and meals, but only 34% believe it protects their independence, privacy, and respect.
🧠 The Alzheimer’s Association launched a national initiative to make earlier diagnosis and access to new treatments part of routine primary care.
🏛️ Dartmouth College and its healthcare system are creating a new Family Caregiver Institute to provide caregivers with education, support services, and access to in-home help.
Open Sesame
There's no magic phrase that makes Medicare Parts A, B, C, and D make sense. But there is a window when Mom can change her coverage, and it's about to open.
From October 15 through December 7, anyone on Medicare can review and change their plan for 2027, with new coverage starting January 1. Even if Mom loves her plan, take another look. Plans change their benefits, networks, and costs every year, and Mom's needs may have changed too.
We've covered Medicare vs. Medicare Advantage before. Here's the CliffsNotes version.
Original Medicare (Parts A and B) is the federal program. Mom can see any provider in the country who takes Medicare. It covers hospital and doctor care but not most prescriptions, so many people add a separate Part D drug plan. It also generally leaves Mom paying 20% of doctor visits and outpatient care, with no yearly cap on what she could owe. A Medigap policy, sold by private insurers, helps cover that gap. It only works with Original Medicare.
Medicare Advantage (Part C) is run by private insurers approved by Medicare. It covers everything Parts A and B do and usually includes prescriptions, but often comes with provider networks and prior authorization.
The right fit depends on Mom's doctors, medications, budget, and where she spends her time. If Mom winters in Naples and summers in your guest room, pay attention. Original Medicare works with any provider in the country who takes Medicare. Most Medicare Advantage plans are local: outside the plan’s service area, they generally cover only emergency and urgent care, so her routine visits while she’s staying with you may not be covered. Some plans offer travel or visitor programs, so ask before assuming.
During Open Enrollment, Mom can:
Switch from one Medicare Advantage plan to another
Move from Original Medicare to Medicare Advantage
Move from Medicare Advantage back to Original Medicare
Join, switch, or drop a Part D drug plan
She can also do nothing. Her plan will generally renew automatically, 2027 changes included.
Before she shuffles anything, two warnings:
Medigap isn't guaranteed. In most states, insurers can review Mom's health, charge more or turn her down once her initial enrollment protections expire, unless she qualifies for special protections. Without Medigap, Original Medicare has no out-of-pocket ceiling. Check her eligibility before she leaves Medicare Advantage.
Don't ditch drug coverage casually. Going 63 days or more without Part D or other qualifying coverage can trigger a late-enrollment penalty that generally lasts as long as she has Part D.
If Mom has Medicare Advantage or Part D, her plan should have mailed an Annual Notice of Change spelling out what's different for 2027. It is not junk mail. Find it and look for changes to:
Premiums, deductibles, and copays
Whether her doctors and hospital are still in-network
Prescription coverage, drug tiers, and pharmacy costs
Dental, vision, and hearing benefits
Prior authorization rules
If her plan is leaving her area entirely, she’ll get a separate notice with her options. Nobody expects you to explain Medicare over Thanksgiving dinner. But you can do the legwork. Start by pulling together:
Her Medicare and insurance cards
Her Annual Notice of Change
A current medication list with dosages
Her doctors, specialists, hospital, and preferred pharmacy
Any new health needs and what she spent this year
Want to keep your favorite child status? Ask Mom:
Have any of your doctors stopped taking your insurance?
Have your prescriptions gotten more expensive?
Has insurance denied anything or made care harder to get?
Which doctors do you absolutely want to keep?
Are you taking new medications or seeing new specialists?
Are you expecting any procedures next year?
Did anything about your insurance annoy you this year?
Then plug her actual prescriptions and pharmacy into Medicare’s Plan Finder tool to see 2027 plans where she lives. Costs vary a lot from plan to plan. Next year, Mom may pay up to $700 for prescriptions before her plan starts sharing the cost, though many plans charge less or nothing at all. Once she’s spent $2,400 on covered drugs, the rest of her covered prescriptions cost nothing until January. Both numbers are up from this year.
If drug bills early in the year will squeeze her budget, the Medicare Prescription Payment Plan spreads her out-of-pocket costs into monthly payments. The total stays the same, but the bills are easier to manage.
Miss the deadline? If Mom has Medicare Advantage, she gets one more chance from January 1 through March 31 to switch Advantage plans or return to Original Medicare and add a Part D plan. She can make one change during that window, and the Medigap warning still applies. People on Original Medicare don’t get this second window, though some life changes, like moving, can open a special enrollment period.
Open Enrollment also brings a flood of ads, calls, and mailers, plenty of them smoke and mirrors. Medicare will never call Mom out of the blue to sell her a plan. For straight answers from people with no commission on the line, start here:
Medicare.gov: the official federal site
Medicare Plan Finder: Medicare Advantage, Part D, and Medigap options in her ZIP code. Enter her prescriptions and pharmacy to see estimated yearly drug costs, plan by plan.
1-800-MEDICARE (1-800-633-4227): questions or help comparing coverage
SHIP: every state's State Health Insurance Assistance Program offers free, one-on-one Medicare counseling. SHIP counselors aren't selling anything.
Pop Quiz
You can’t fail this one. Answers and another quiz drop next week.
Is your parent on Original Medicare or Medicare Advantage?
Parenting Parents
You said it. This week’s submissions.
"Mom is in complete denial about her health issues."
"I used to call my dad when something went wrong; now I'm the one he calls, and I miss how things used to be."
"My mom seems too proud to introduce me when I visit her new memory care community."
"My dad's favorite hobby is telling me how much things used to cost."
"I love that my mom still calls to make sure I got home safely."
"I never imagined watching our parents age would bring my siblings and me closer together."
