The role of family caregivers in Custodial Care and how Medicare supports them

As your loved one ages, their care needs may become uncertain. However, there are various care options available based on their preferences, medical conditions, and home environment. These options range from medical to non-medical in-home services, such as custodial care, which is suitable for seniors who require assistance with daily activities but still want to maintain their independence. Custodial care involves a professional visiting the senior’s home to provide companionship and help with tasks like eating and bathing. The caregiver establishes routines to meet the senior’s needs and put family caregivers at ease. Understanding the duties and benefits of custodial care can assist in selecting the best care option for your loved one.

Will Medicare Cover Caregivers?

Beneficiaries of Medicare can access coverage for in-home medical care provided they meet certain criteria. The coverage includes skilled nursing care, physical therapy, occupational therapy, speech-language pathology services, medical social services, and injectable osteoporosis drugs for women if necessary. To qualify for in-home care services, beneficiaries need to be assessed as homebound by a medical practitioner, meaning they are unable to leave their home for medical care and can only leave the house occasionally, for example, to attend religious services. Nonetheless, beneficiaries enrolled in an adult day care program are eligible for home health care coverage.

Medicare Part A would cover home health services for 100 days if a beneficiary was admitted to the hospital or skilled nursing facility for three or more consecutive days. Medicare Part B covers home health services if it is medically necessary and the patient was not hospitalized before. Medicare Advantage (Part C) also covers home health services, but beneficiaries should ensure that the service providers are in-network to avoid additional expenses. Prescription drug coverage (Part D) is not included in Original Medicare plans and must be added separately. Supplemental Medicare plans may help beneficiaries with certain home healthcare costs not covered by Medicare, but they may also require beneficiaries to use in-network providers.

Tips for Caregivers

It is crucial for caregivers to communicate with beneficiaries and comprehend their preferences regarding finances, healthcare needs, and other related matters. As a caregiver, it is vital to initiate discussions with the beneficiary about the following topics:

  • Personal identification number such as Social Security Number.
  • Medicare identification number.
  • Medicare coverage plans.
  • Contact details of other healthcare providers such as doctors, nurses, specialists, and pharmacists.
  • A comprehensive list of current medications.
  • Information about current medical conditions, treatment plans, or symptoms.
  • Medical history.
  • Allergy information, if applicable.
  • A list of emergency contacts.

Also, every good caregiver should be familiar with the patient’s Medicare coverage. Beneficiaries have a variety of insurance coverage options beyond their Original Medicare plans, including Medicare Advantage Plans, Medigap Plans, Medicaid-Medicare Plans, Medicare Savings Plans, Part D Prescription Drug Plans, and additional benefits like financial assistance for veterans and state/county financial aid. When caring for someone with chronic illness, caretakers should be aware of ongoing symptoms, specialists, and treatment plans, and have an action plan for potential complications. Depression and anxiety are common, and therapy or support groups may help. If hospitalization is necessary, caregivers should know what Medicare Part A covers, such as inpatient hospital care and certain services. For full-time care, nursing home and housing options include independent living, assisted living, continuing care retirement communities, adult day care, custodial care, skilled nursing facilities, and nursing homes. Medicare coverage for full-time care or nursing homes can be complex, so consulting a licensed insurance agent is recommended. Hospice care is an option for terminally ill beneficiaries. Caregivers should discuss a plan of action with the beneficiary and ensure they meet Medicare criteria for coverage through Medicare Part A.

Will Medicare Provide Coverage for Medical Supplies?

Medicare Part B provides coverage for durable medical equipment (DME), which includes medical supplies. If a physician determines that a patient needs a certain DME, Medicare Part B will cover it. However, for Medicare to cover the cost of DME, the supplier must be in-network, and patients have the option to rent or purchase the equipment. DME encompasses a range of equipment, including but not limited to blood sugar monitors, canes, walkers, wheelchairs, CPAP devices, hospital beds, oxygen equipment, and traction equipment.

To qualify as DME, the equipment must meet certain criteria, including being able to withstand continuous usage, being medically necessary, being used by an ill or injured individual, being operated on within the patient’s home, and having a lifespan of at least three years.

If I’m a Family Caregiver Can Medicare Support Me?

If you are a family caregiver, you may be unsure about hiring in-home care. However, a custodial care professional can ease your concerns and help you find balance in your life. By learning more about in-home care options, you can select the best choice for your situation.

Caregivers can potentially earn money by applying for Social Security disability benefits on behalf of the care recipient. Social Security disability benefits include Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). SSDI is available to those who have paid Social Security taxes and have worked within the past ten years. SSI benefits are need-based and available to family members who may serve as family caretakers. Detailed financial and living situation information is necessary to determine the exact benefits.

However, Medicare does not fund full-time medical care or support, but it can provide funding for medical supplies and equipment. Part-time or intermittent healthcare services may be covered. If you want to pay a family member to be a caregiver, Medicaid may be a more viable option. Self-directed Medicaid services for long-term care are available in all 50 states, allowing individuals to manage their own long-term care services and needs. In some states, these services can include hiring a family member or someone else to be a caregiver.

If you have any additional questions about Medicare coverage and custodial care you can get a help of an experienced Medicare insurance agent. Contact Temmen insurance, we are an insurance company that puts our client’s interests first. Let’s begin our journey together!

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