Are You a Caregiver? How to Decide on the Right Medicare Option for Your Loved Ones

A recent Wall Street Journal article highlighted the story of an 80-year-old man who was a caregiver for his 101-year-old mother. It’s estimated that over 19% of all caregivers are 65+ themselves.  

Oftentimes, it can be difficult choosing coverage for a loved one since we want to make sure they’re getting the “very best” plan possible.  

Sometimes, this mentality can mislead caregivers and result in overlooking certain plans. 

With Medicare, the age-old decision has always been between Medicare Supplement (Medigap) plans and Medicare Advantage (Part C) plans. Medicare supplements typically offer more robust medical coverage (low or no co-pays) and more flexibility in providers in exchange for higher monthly premiums. 

Medicare Advantage plans typically have lower monthly premiums and extra services such as dental/vision/hearing/caregiver benefits in exchange for limits on the network and higher co-pays. 

Historically, caregivers typically opted for higher-cost supplemental plans given the more robust medical benefits for their loved ones. However, as Medicare Advantage plans have started to add more and more benefits that are not covered by Medicare itself, the scales have started to tip.

We wanted to highlight 2 common scenarios we see and provide a framework for caregivers to make an educated decision when it comes to the level of coverage.

1) Your loved one is managing a large number of medical conditions requiring frequent procedures, doctor visits, and lots of interventions such as in cases of cancer, end-stage renal disease, or stroke.

If your loved ones require frequent hospitalizations, cancer treatments, procedures, or medical services, we would still opt for most caregivers to consider a traditional Medicare supplemental plan. Traditional supplemental plans require minimal or no co-pays for Medicare-approved services and do not have restrictions such as referrals. This can make booking appointments and getting treatment a lot easier for both you and your loved one.  

2) Your loved one is suffering from cognitive issues and if serious medical issues arise, there is less of an inclination to opt for intervention. 

For caregivers that may be taking care of a loved one with cognitive conditions toward the end of life such as Alzheimer's, there’s typically an inclination to minimize medical intervention. In these cases, a Medicare Advantage plan may be an option to consider versus a Supplement. Many Advantage plans (depending on your area) offer additional benefits such as extra home visits from a provider, rides to services, and some have started to offer allotments for professional caregivers and groceries. 

These extra benefits could amount to a great deal of relief for caregivers both in effort and finances. Given that the individual in need of care may not be going to the hospital or needing additional services if something major were to happen, the extra co-pays may not be as applicable.