Edit Content

Specializing in consulting services to help providers with payer management to increase revenue, reduce waste, and streamline their operations.

Get in touch

My Grandparents Medicare Enrollment


This is an interesting story about my grandparents’ experience with Medicare enrollment. To start, my grandparents are in their 70s now, both in relatively good health. They are currently participating in Medicare Part A and B with prescription coverage. My grandmother kept complaining about the cost of the prescription coverage on their social security statement, premiums are automatically deducted from their check. The premium was a little over $100 per period. The larger issue is they were paying out of pocket mostly for their prescriptions. Basically, the plan wasn’t really covering much of anything. My grandparents, probably similar to yours, only had the paperwork for the coming benefit year, not their initial enrollment documents. They originally enrolled in 2006. In 8 years, my grandma watched the premium change without saying anything, until she finally had enough.

This just happened to be with 3 days left in the enrollment period. All changes to insurance coverage adjustments have to be made during this period or you are locked in for another year. She sent me an entire binder of documents to read though in 2 days. While I managed to read the material rather quickly, there was no documentation to discern what the deduction should have been this entire time.

Social Security is stating the amount is the premium from their prescription plan. The prescription plan notes the premium as $36 dollars. So my grandparents must have enrolled in another plan. It turns out they are enrolled in 3 different plans….

My grandma is enrolled in a discount prescription plan, while my grandpa participates in a traditional prescription Medicare Advantage plan. However, they are both enrolled in another prescription plan that neither of them is currently using. I’m not even sure how this happened. The paperwork must have been similar. They’ve been paying for multiple prescription plans the past few years, approximately. My grandma as a discount plan, so she at least has part of her drug costs covered at each visit. However, my grandpa pays roughly $900 a year in premiums, deductible, and cost sharing. While their out of pocket cost without insurance is roughly $800 a year. He is paying more to get less. This might seem strange, but truly this happens all the time.

My goal is to bring some consistency to their lives this year. I’m reviewing all the paperwork for medical, vision, dental, and prescription. While I was only able to resolve one problem before the end of open enrollment, next year I’ll be ready on day 1. Have you had any similar experiences? Should Medicare enrollment be so finite?

Share Post:

Continue reading

We Have the Connections

How to Find the Right Consultant

The Importance of Network Development

Never Over Pay!

Medical Bills No More