Medicare and Caregivers

An estimated 34.2 million Americans provide unpaid care to an adult age 50 or older. If you’re a caregiver, it’s important to understand the coverage and benefits Medicare can offer you and your loved one.

What Should Caregivers Know About Medicare?

Medicare is a federal government health insurance program primarily for people age 65 and older. It may also cover younger adults with disabilities.

There are different plans and coverage options within Medicare.

Your loved one or family member may be enrolled in Original Medicare, which includes two components: Part A for hospital insurance and Part B for medical coverage.

In this case, your loved one may also have a stand-alone Part D prescription drug plan. Some Original Medicare beneficiaries also have a supplemental insurance plan, also known as Medigap, which helps cover deductibles and other costs.

Part D and Medigap plans are administered by private companies that Medicare reimburses.

Alternatively, your friend or family member may be enrolled in a Medicare Advantage, or Part C, plan.

This option is also administered by a private company. Medicare Advantage plans must provide the same basic coverage as Original Medicare but may also bundle other benefits — such as drug coverage, vision, hearing and dental — into a single plan.

All Medicare enrollees are issued a red, white and blue Medicare card. They may also have a separate Medicare Advantage or Part D card, if they’re enrolled in these programs.

If you can’t locate these cards, you and your loved one can call the Medicare helpline together. Or, your loved one can complete a form authorizing Medicare to release information to you.

To learn more, call Medicare at 1-800-MEDICARE (1-800-633-4227).

It’s helpful to have certain information handy as you navigate your loved one’s Medicare coverage.

Try to gather the following details about your friend or family member:
  • Social Security number
  • Medicare number and type of Medicare coverage
  • Other insurance plans and policy numbers, including long-term care and Veteran Affairs benefits
  • Phone numbers and names of doctors, specialists, social workers and pharmacies
  • Current list of prescriptions and over-the-counter medications
  • List of health conditions, treatments, symptoms and past surgeries
  • Any allergies or food restrictions
  • Emergency contact phone numbers
  • Important end-of-life documents, including a living will, last will and testament and medical power of attorney
Tip
If you have general questions about Medicare coverage, you can contact your State Health Insurance Assistance Program, or SHIP. This organization gives free health insurance counseling and guidance to Medicare enrollees and their families.
Source: State Health Insurance Assistance Programs

Understanding Prescription Drug Plans

Many caregivers are responsible for administering medications for a loved one.

Ways Medicare Beneficiaries Can Receive Prescription Drug Coverage
  1. Through a stand-alone Medicare Part D drug plan.
  2. Through a Medicare Advantage plan with built-in drug coverage.

Private insurance companies approved by Medicare offer Part D plans. Monthly fees can vary, and drug costs depend on the plan you select.

Each plan has its own formulary, or a list of covered medications. This list sets the price for each drug.

If the person you care for takes specific prescription drugs, make sure to research each plan’s formulary to ensure their medications are covered.

Keep in mind that no plan covers every drug. Plan costs — including premiums, deductibles and copays — can change from year to year.

Does Medicare Cover Caregiving Services?

Medicare may help cover home health care and skilled nursing care for your loved one or family member.

Examples of Home Health Services Covered by Medicare
  • Part-time skilled nursing care
  • Physical, occupational or speech therapy
  • Medical social services
  • Part-time home health aide services

Medicare beneficiaries must meet certain criteria in order to qualify for home health care. For example, your loved one must be homebound and receive services under a plan of care created by a doctor.

If your loved one or family member is eligible, Medicare will pay all costs for home health care services ordered by a doctor and administered by a certified home health agency.

Some home health services are never covered by Medicare, including:
  • 24-hour home care
  • Personal care — such as help with bathing, dressing and eating — when this is the only care needed
  • Meal delivery
  • Homemaker services, such as grocery shopping or light housework
Tip
Talk to your loved one’s doctor or home health agency to see which services are covered. You can call 1-800-MEDICARE for more information.
Source: U.S. Centers for Medicare & Medicaid Services

Financial Aid and Resources for Caregivers

It can be financially challenging to care for a loved one.

About 28 percent of caretakers say they have stopped saving money while another 23 percent say they’ve taken on more debt, according to a 2020 report by AARP and the National Alliance for Caregiving.

In some cases, you may be able to get paid as a family caregiver — particularly if you care for a U.S. military veteran or someone eligible for Medicaid.

There are four plans that allow U.S. veterans to pay a loved one or family member for caretaker services.

Veteran Directed Care, for example, is a program available to qualified former service members who require nursing home-level care but who want to remain in their own home or the home of a loved one.

This program is available in 37 states and gives veterans who are enrolled in the Veterans Health Administration health care system a monthly budget to pay for goods and services. This can include payment for family caregivers, such as a child, grandchild or spouse.

Medicaid also has a self-directed care option. However, coverage, eligibility and rules vary from state to state.

For example, some state programs may pay family caregivers but will not pay spouses or legal guardians. Other states won’t pay caregivers who live with the care recipient.

These Medicaid programs can go by different names, including Consumer Directed Care, Participant-Directed Services or In-Home Supportive Services.

Tax Breaks and Credits for Caregivers

Even if you aren’t eligible to receive compensation as a family caregiver, you may qualify for tax breaks.

To receive these tax credits, the person you care for must be a dependent. You may be able to claim your parent as a dependent if they live with you and you supply at least 50 percent of the household income.

You may qualify for a dependent care credit on your tax return if you paid someone else for caregiving services while you worked.

Or, you may qualify for a medical expenses’ deduction if you paid your loved one’s medical bills. This includes the cost of long-term care insurance.

Importance of Taking Care of Yourself

Taking care of a loved one may feel like a full-time job — but it’s important to take care of yourself, too.

Maintaining healthy habits and utilizing available support can help reduce your stress and prevent fatigue.

Resources for Caregivers of Medicare Beneficiaries
Benefits Checkup
This online service is provided by the National Council on Aging to help older adults and their families explore federal, state, local and private assistance programs.
Eldercare Locator
This website connects people over age 60 and their caregivers with their local Administration on Aging’s Family Caregiver Support Program, state Medicaid program and community resources.
CareJourney
The Family Caregiver Alliance offers an online service called CareJourney that features information, support and resources tailored to your specific caregiving situation.
Last Modified: October 2, 2020

9 Cited Research Articles

  1. AARP. (2020, May 15). Can I Get Paid to Be a Caregiver for a Family Member? Retrieved from https://www.aarp.org/caregiving/financial-legal/info-2017/you-can-get-paid-as-a-family-caregiver.html
  2. AARP Public Policy Institute. (2020, May 14). Caregiving in the United States 2020. Retrieved from https://www.aarp.org/ppi/info-2020/caregiving-in-the-united-states.html
  3. Medicare.gov. (2019, November 8). There’s help for caregivers, too. Retrieved from https://www.medicare.gov/blog/help-for-caregivers-2019
  4. Salopek, J. J. (2019, October 11). Medicare Home Health Benefits: What Caregiving Costs Are Covered. Retrieved from https://www.aarp.org/caregiving/financial-legal/info-2019/medicare-home-health-care-benefits.html?intcmp=AE-CAR-LEG-EOA1
  5. Family Caregiver Alliance. (n.d.). Frequently Asked Questions (FAQs). Retrieved from https://www.caregiver.org/frequently-asked-questions
  6. Family Caregiver Alliance. (n.d.). Taking Care of YOU: Self-Care for Family Caregivers. Retrieved from https://www.caregiver.org/taking-care-you-self-care-family-caregivers
  7. Medicare.gov. (n.d.). Home health services. Retrieved from https://www.medicare.gov/coverage/home-health-services
  8. The National Alliance for Caregiving. (n.d.). Help for Caregivers. Retrieved from https://www.caregiving.org/resources/
  9. U.S. Department of Health and Human Services. (n.d.). National Family Caregiver Support Program. Retrieved from https://acl.gov/programs/support-caregivers/national-family-caregiver-support-program