According to the most recent census, one in six Americans is over 65, and most are expected to live at least two decades longer. By 2060, 25% of the U.S. will be 65 years and older, and the number of those aged 85 and older will triple. As our population ages, the need for quality caregiving rises. According to the National Alliance for Caregiving, one in five Americans is now in a caregiving role, contributing billions of hours of care for family members who need support and are typically unpaid for their time and labor.
Caregiving looks different in every situation; for some, it means driving to appointments, running errands, helping with home repairs, etc. For others, it means comprehensive live-in care for someone who needs physical assistance completing basic tasks and caring for their health. Many caregivers also manage finances, healthcare and other forms of insurance for their loved ones, which can be confusing and overwhelming for someone unfamiliar with financial benefits like Medicare, Social Security Disability Insurance and more.
It is estimated that 21% of people who receive support from a caregiver are enrolled in Medicare, meaning that a significant number of caregivers will be facing difficult decisions about coverage, types of services available, costs and more as they aim to select Medicare coverage that suits the unique needs of their parent or loved one. Knowing what your loved one’s healthcare coverage entails and what questions to ask is important for providing the support they need.
To help you get started, we’ve prepared a checklist about what you should know as a caregiver navigating the Medicare process for a family member.
Make sure you are a designated power of attorney and/or healthcare proxy.
Also called a durable medical power of attorney, healthcare agent or healthcare surrogate, this is essential to being able to help with your loved one’s healthcare, including Medicare. It grants you the legal right to make healthcare decisions if your loved one cannot do so on their own. Once in place, provide a copy to all medical providers and upload a copy to the Medicare portal.
Ensure you have access to medical documentation.
When dealing with a Medicare claim, it will be vital to provide medical records, insurance information, contact information for providers, a list of prescriptions and more to find a Medicare plan that includes existing providers, treatments, etc. If you do not have this information on hand already, we strongly recommend reaching out to your loved one’s providers to obtain it so you are ready to seek out a Medicare plan that meets their unique needs when the time comes.
Learn about your parent or loved one’s Medicare plan (if they have one).
- If they have Original Medicare (Parts A and B), focus on understanding what’s covered. While family caregivers are not compensated under Medicare, it’s important to know about the caregiving services that are covered.
- If they have a Medicare Advantage plan, they may be able to take advantage of resources like meal deliveries, rides to appointments, gym memberships and more – all of which could help improve their quality of life and save money.
- If they have a Medigap (or Medicare Supplement) plan, these plans align with what Medicare covers and fill the gaps by paying co-pays, deductibles and coinsurance. Where a co-pay applies, for example, on durable medical equipment, these plans may help.
If they haven’t enrolled in Medicare yet but are 65 or older, seek support.
Evaluating the options available and what will work best for your parent or loved one can be overwhelming. Seeking the right resources to guide you through the process can ease the strain and inform you about all available choices. Medicare has an eligibility tool to get you started, and you can also call Aevo to ask questions about your loved one’s Medicare eligibility or explore their benefit options.
Look into the caregiving resources available through Medicare.
With the passage of an Executive Order in 2023, family caregivers now have additional resources available. Under the rule, which went into effect January 1, family caregivers who have parents/family members with certain high-risk illnesses (i.e., cancer, dementia or HIV/AIDS) may be able to get Medicare to cover services that will help them better understand the condition and any available healthcare options.
Family caregiver training is also available and paid for by Medicare in cases where a medical provider deems it necessary for a patient’s treatment plan. Medicare will pay the provider for their time, training family caregivers to administer injections, change bandages and more.
The role of a family caregiver is becoming increasingly important and complex. Leveraging the resources, tools and services available is vital to the well-being of the caregiver and their loved one. When it comes to Medicare, being prepared to help and knowing what can be done as a family caregiver will go a long way in creating the best possible outcomes for all involved.
Bookmark These Valuable Medicare Resources
- Medicare.gov
https://www.medicare.gov/my/home
- Medicare and You
https://www.medicare.gov/medicare-and-you
- Aevo Services – All About Medicare
https://www.aevoservices.com/about-medicare/
