Part D for Caregivers: Managing a Parent's Medications

If you help a parent manage prescriptions, you have probably hit the same wall every caregiver hits: the pharmacy or plan will not talk to you. Medicare privacy rules bar a Part D plan from discussing a beneficiary's account with family unless authorization is on file. Here is how to set that up, and how to handle the practical work once you can.

Step 1: Get authorized to speak to the plan

Get the paperwork in place first — without it, you cannot ask about a denied drug or request an exception.

• CMS-1696, Appointment of Representative. This is the form a beneficiary signs to appoint someone to file coverage requests, grievances, and appeals on their behalf. Both the beneficiary and the representative sign it, and it is submitted to the plan for Part D matters. Unless revoked, an appointment is generally valid for one year from the date it is signed, so calendar a renewal.
• The plan's own authorization form. Many plans also have their own form for letting a family member discuss the account. Ask the plan which form it requires — a CMS authorization does not automatically carry over to every private plan.
• If your parent cannot sign. A court-appointed guardian, or someone holding a durable power of attorney or health care proxy, can generally act as an authorized representative under state law. The plan will ask to see the legal documents.

Do this before a crisis — it is a short form while your parent can sign, and much harder after a hospitalization.

Step 2: Review the plan once a year, during AEP

Annual Enrollment Period runs October 15 through December 7 each year, and it is the one window when your parent can switch Part D plans for the following year. Plans change formularies, preferred pharmacies, and cost-sharing every year, so last year's cheapest plan may not be cheapest next year. The review takes about 30 minutes:

1. List every drug your parent takes, with dose and frequency, and note any over-the-counter products that interact.
2. Enter the list into Medicare.gov Plan Finder along with their preferred pharmacy, and compare total yearly cost — premium plus copays — not just the monthly premium.
3. Check that each drug is on the new plan's formulary, and at what tier. A drug that moved to a higher tier or gained a prior authorization requirement is the most common cause of a January surprise.
4. Confirm the pharmacy is preferred, not just in-network. Preferred pharmacies charge lower copays, and the difference adds up over a year of refills.

Step 3: Simplify refills so nothing falls through the cracks

Missed refills are one of the biggest risks for older adults on multiple medications. Three tools help:

• Mail-order 90-day supplies. Most plans offer 90-day fills by mail, often at a lower copay than three 30-day fills at a retail pharmacy, and it removes the weekly pharmacy trip.
• Synchronized pickup dates. Ask the pharmacy to align refill dates so all medications come due on the same day each month, making a missed drug easy to spot.
• A single medication list. Keep one current list — drug, dose, prescriber, and purpose — in your parent's wallet and in your phone, and bring it to every doctor visit. When a new drug is prescribed, check it against the list for duplicates and interactions before filling it.

Covered insulin costs no more than $35 for a 30-day supply in 2026, and the deductible cannot be charged on it — but confirm the plan covers your parent's specific insulin product, since the cap applies to covered insulin on the plan's formulary.

Step 4: Know the costs — and the safety nets

In 2026, the standard deductible is up to $615, and once out-of-pocket spending on covered drugs reaches $2,100, your parent pays $0 for covered drugs for the rest of the year. The old coverage gap was eliminated in 2025.

Two safety nets are worth knowing about:

• The Medicare Prescription Payment Plan. This free, optional program spreads out-of-pocket drug costs into monthly payments over the year instead of large amounts at the pharmacy counter. It does not reduce total cost, but it smooths cash flow when a high-cost drug hits in January.
• Formulary exceptions and appeals. If a needed drug is not covered or sits on a high tier, the prescriber can request an exception or coverage determination. As an authorized representative, you can file and follow up on that request — exactly what the CMS-1696 paperwork enables.

If costs are still unaffordable, check Extra Help through Social Security or a State Pharmaceutical Assistance Program — many eligible beneficiaries never apply.

What to keep in one place

Keep the paperwork in one folder, paper or digital: the signed CMS-1696 and plan authorization forms with renewal dates, power of attorney or guardianship documents if applicable, the current medication list, plan denial letters and exception approvals, and a call log with dates, names, and reference numbers.

You do not need to be an insurance expert to do this well: authorization on file, one annual plan review, refills on autopilot, and a folder that answers questions before they become emergencies.> Bottom line: Get authorized with CMS-1696 and the plan's own form, review the plan every fall during AEP, and use mail-order refills and the $2,100 out-of-pocket cap to keep your parent's medications affordable and on schedule.