Once your parents qualify for Medicare, their specific health needs and budget can help determine which Medicare plan they may benefit from most.

Enrolling in Medicare can be a confusing process. Your parents can choose to enroll in Original Medicare (parts A and B) or a Medicare Part C (Medicare Advantage) plan.

With Original Medicare, your parent can also enroll in a stand-alone Part D plan for drug coverage and a Medicare supplement plan to help them with their out-of-pocket costs.

Part C plans offer the same benefits as Original Medicare, but they have different costs. Some Part C plans also offer prescription drug coverage and other benefits.

Read on to learn what to consider when helping your parents make the best choices for them.

To help your parent think about the best healthcare coverage for them, you can suggest they consider the following factors:

  • Do they have any existing health issues that require regular and consistent follow-up care?
  • Do they anticipate any potential future health conditions that might need particular management?
  • Are they on any short- or long-term medications?
  • Would they benefit from specific services, such as fitness or dental care?

Once you fully understand their current health and future needs, you can help them find a plan that meets those requirements.

Understanding how Medicare is structured and what parts and plans are available is important for helping your parents decide which Medicare plan works best for them.

Generally, Medicare can be broken down into the following parts based on what they cover and how they’re administered:

  • Original Medicare: This consists of Part A, which covers hospital care, including various hospital-related services, and Part B, which covers general medical and outpatient care you may need to stay healthy.
  • Medicare Advantage: Part C is not a separate medical benefit but a provision allowing approved private insurance companies to provide insurance plans to people enrolled in parts A and B. Your parent can enroll in Part C instead of Original Medicare. Part C plans cover the same benefits, and they may offer extra coverage like vision or dental.
  • Part D: Part D covers prescription drugs. Your parent can enroll in Original Medicare plus a stand-alone Part D plan; Part C plus a stand-alone Part D plan; or a Part C plan that includes drug coverage, which is known as a Medicare Advantage Prescription Drug (MAPD) plan. Not all Part D and MAPD plans cover the same drugs, so choosing a plan depends on the prescriptions your parent may need.
  • Medigap: Medicare supplement plans help cover out-of-pocket costs that Original Medicare doesn’t. There are 10 standardized Medigap plans — A, B, C, D, F, G, K, L, M, and N — that vary in coverage.

Advantages of Medicare Advantage

Disadvantages of Medicare Advantage

  • Limited service providers: Choosing a popular Part C plan, like an HMO, may limit your provider options and result in higher fees for out-of-network care. Other plans offer more provider freedom but often come with higher premiums and additional costs, like copays and deductibles.
  • Prior authorization: While Original Medicare rarely requires prior authorization for services, Medicare Advantage plans tend to add the procedure requirement. This may lead to more service denials.
  • State-specific coverage: Original Medicare offers the same coverage to people across the United States. Medicare Advantage plans may offer specific coverage in specific service areas only.

Another factor to consider about different Medicare plans and parts is the differences in cost.

Original Medicare

Most people do not pay a premium for Part A because they’ve worked and paid taxes in the United States for at least a decade. Individuals who do pay a premium will pay $285 or $518 monthly in 2025, depending on how long they’ve worked and paid Medicare taxes.

In addition, your parent will have to meet a $1,676 deductible for Part A.

Once they do, Part A will fully cover their hospital stay and any rehabilitation services needed following surgery for the first 2 months. After that, your parent will incur an additional daily cost, and after day 101, they’ll be responsible for the full cost. For stays in skilled nursing facilities, this additional cost begins on day 21.

The Part B monthly premium starts at $185 and increases depending on your parent’s income bracket. After they meet the deductible, which is $257 in 2025, Part B will pay for 80% of any covered treatment or service. Your parent will pay the remaining 20%.

Parts C and D

Both Part C and Part D are privately managed plans. This means they have different premiums, deductibles, and coinsurance depending on the plan.

Under Medicare Part D, the amount your parent will pay out of pocket for prescription medications depends on the tier (level) the plan classifies the medication into on its formulary (a list of covered drugs). The higher the tier, the more expensive the drug will be, even after coverage kicks in.

Because private companies manage Part D plans, each plan provider can charge different premiums and have different deductibles. The national base beneficiary premium, which is the starting point for calculating premiums, will be $36.78 in 2025.

Similarly, premiums and deductibles can differ for Part C plans. According to the Centers for Medicare & Medicaid Services (CMS), the average monthly premium for Part C plans will be around $17 in 2025.

In addition, to be enrolled in a Part C plan, you still have to pay the Part B premium. That said, some Part C plans may cover your Part B premium.

Medigap

Medigap plans are also private and have monthly premiums. These premiums depend on which of the 10 plans you choose. They may be:

  • Community-rated: This means they’re the same for everyone in a specific area.
  • Issue-age-rated: This means they’re based on how old your parent is when they enroll.
  • Attained-age-rated: This means they increase with your parent’s age.

The Medigap premium is an additional cost to Original Medicare, and Medigap plans cannot be used with Part C plans. Some plans offer higher deductible options with lower premiums, and others offer out-of-pocket limits.

When helping your parent enroll in Medicare, you also need to determine if they’re eligible and whether they’re already enrolled. Medicare eligibility is based on being age 65 years or above or receiving certain disability benefits.

If your parent is eligible based on disability, they’ll be automatically signed up for Medicare parts A and B. Their Medicare card and enrollment information will be mailed to them.

If they are not automatically enrolled, they must apply for Original Medicare (parts A and B) and any additional coverage they want.

There are three enrollment periods to be mindful of:

  • Initial enrollment period (IEP): Starting 3 months before their 65th birthday, your parent can enroll in Original Medicare. The IEP runs through their birth month and ends 3 months after that.
  • Special enrollment period (SEP): If they miss their IEP, your parent may be able to sign up for Medicare during an SEP.
  • Open enrollment period (OEP): Medicare’s OEP, sometimes called an annual enrollment period (AEP), is between October 15 and December 7 each year. At this time, they change coverage within Medicare.

If your parent is already enrolled in a Medicare plan, there are a few important things to remember:

Annual notice of change letter (ANOC)

An ANOC is sent every fall by Part C or Medicare Part D plans. This letter outlines any changes in coverage or costs for the following calendar year, so it’s important to review it to decide whether your parent needs to change their coverage.

Using a broker

Your parent’s specific needs will determine the right Part C, D, or Medigap plan for them. Licensed insurance brokers can help review options and enroll your parents in suitable plans at no cost. Note that brokers are compensated by the insurance companies they work with, which may affect their recommendations.

Alternatively, you may consider reaching out to the State Health Insurance Assistance Program (SHIP) for assistance with plan selection and enrollment.

Disclosure of Medicare information

If your parents fall seriously ill before enrolling in Medicare, you may need to act as their healthcare proxy and enroll them in Medicare, including choosing which plan to enroll them in.

If possible, have your parent fill out an Authorization to Disclose Personal Health Information form so that you can do this on their behalf.

If they are unable to grant authorization due to illness or injury, such as a stroke or dementia, your only option may involve getting a court order.

Signing up for Medicare can be complex, so you may wish to help your parents select and enroll in the best plan for them.

Your parents can choose between Original Medicare (parts A and B) and a Medicare Part C (Medicare Advantage) plan. Both provide the same advantages, but they vary in cost. Some Part C plans also include prescription drug coverage and additional benefits.

Additionally, your parents can opt for a separate Part D plan for medication coverage and a Medicare supplement plan to assist with the out-of-pocket expenses associated with Original Medicare.

Once your parents are eligible for Medicare, the plan that most benefits them will depend on their unique health requirements and financial situation.