Medicare for Caregivers


Providing care for a loved one can be challenging. It takes a great deal of time, effort, and emotional labor. On top of that, you suddenly have to navigate the world of insurance, with its paperwork, hoops, and unintuitive structures. Understanding Medicare can be an important part of being a caretaker. The good news is that you have tools at your disposal. Here are a few tips to help you get started.

Tip 1: Make Sure You’re Authorized

In order to make medical decisions for the person you’re taking care of, you’ll need authorization. You may already have a medical power of attorney. That’s a good start. (If you don’t have one, you should work on securing one. It could be important if the person you’re helping can’t make decisions for themselves, or becomes unable to do so.)

But sometimes a power of attorney isn’t enough. If your loved one needs help managing Medicare benefits, you should become an Authorized Representative. This allows Medicare to disclose health information to you, and lets you help them choose a plan, manage benefits and payments, and more.

Any other insurance companies involved in care may also need authorization, either verbally or through a form, to share information with you and let you make decisions.

Tip 2: Know the Parts of Medicare

Original Medicare is comprised of Part A and Part B. Both parts pay 80% of covered costs, leaving you with 20% of the remaining cost. Each part covers different types of care.

  • Part A covers hospital care. This includes hospital stays, inpatient nursing care, and supplies. It also covers hospice care and in-home nursing. For most people, there is no monthly premium for Part A.
  • Part B covers other types of medical care. This includes outpatient services, ambulance rides, mobility assistance, lab tests, surgeries, and preventative care. There is a monthly premium for Part B.

There are other types of Medicare plans, as well. These types of Medicare are regulated by the government, and designed to work with Original Medicare. However, the insurance plan itself is provided by private insurance companies.

  • Medicare Advantage, or Medicare Part C expands the types of care that Original Medicare covers. For example, Medicare Advantage plans often include hearing care, routine eye exams, and dental services. These plans usually include Medicare Part D coverage. There are plans available at $0, but you typically have to pay an extra premium for this coverage.
  • Medicare Part D provides coverage for prescription medications. While it’s often included in Part C, it’s also available as a standalone product.
  • Medicare Supplement Insurance helps cover out-of-pocket costs that Original Medicare may leave you with. It won’t expand the types of care you can receive, like Part C does. Rather, it helps cover expenses like deductibles, coinsurance and copays. You’ll pay an extra premium for a Medicare Supplement plan.

Unfortunately, a person can’t have Medicare Advantage and Medicare Supplement together. Choosing between them depends on each person’s unique medical needs.

Tip 3: Know About Long-Term Care

Currently, Medicare doesn’t cover long-term care to help with activities of daily living. (This is called “custodial care.” The only exception is if the provider is also providing some kind of medically-necessary treatment alongside the rest of the long-term care.)

However, recent changes in guidance from Medicare mean that Medicare Advantage plans could start rolling out long-term care options in the future. Since this is a recent change, it’ll probably take insurance companies some time to figure out how to set those plans up, but they may become available in the near future.

Most Importantly: Take Care of Yourself

Dedicating so much of yourself to the care of another person can be stressful. No matter how much you love them, it can still be draining. Make time for yourself. Schedule things you enjoy, that let you take your mind off of your responsibilities as a caretaker. Taking time to restore yourself can make you a fresher, sharper person, who’s better able to deal with the responsibilities you’re facing.

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