Welcome to the ultimate guide to caring for elderly parents and/or grandparents. Aging is a natural part of life, and everyone should have a care plan for themselves and their aging loved ones. This guide helps you make the tough decisions to keep your loved ones safe and happy.

I personally know what it is like to live with elderly loved ones and care for them. I lived with my grandparents right before their health declined enough to move them to assisted living. It was the hardest year of my life. However, it was also rewarding to care for them after all of the years they cared for me.

Where can my loved ones safely live?

Helping your elderly parents or grandparents decide where they should live can be very emotional. This is true for all the people involved. The options range from staying at home to full-time care, and everything in between.

Senior Living Options

• Living at Home – Options exist for helping your seniors live at home as long as possible.
  • There are non-medical care-giving services such as Home Instead and Right at Home. They provide help around the house and companionship, but not medical care.
  • The medical alert devices listed in the services in the next section also help give seniors and you peace of mind in regards to their safety. These are good for the home environment, as well as running around town.
• Retirement Community / Apartment or Condo – Often times seniors will want to move to a retirement community or 55+ apartment or condo building. Seniors like the social aspects of these communities. In addition, there are add conveniences and informal safety networks in place to give everyone peace of mind.
• Assisted Living – For seniors that need a level of care below the nursing home, assisted living is a great option. However, these homes can be expensive. There are not always spots open for low income or Medicaid beneficiaries.
• Memory Care Centers – Dementia and Alzheimer’s is a growing disease in America. As a result, we see more centers and homes dedicated to residents with memory issues.
• Nursing Homes and Long-Term Care – The last stop on the list is the nursing home / long-term care facilities. There are both private and public options in most cities, but it takes a lot of research to make sure you are finding the best fit for your loved one.
  • The government has a web-page to help you in comparing nursing home quality here.

What services / products can keep elderly loved ones safe and happy?

Especially if your loved ones are living at home, there are different products and services that can give everyone peace of mind. These include aides to help with daily activities, as well as alert / check-in services.

Products to Keep Your Loved Ones Safe & Happy

We love products that keep seniors happy, independent and safe. Happily, more creative and innovative options exist that ever to make life easier. We are constantly on the hunt for life-improving and safety-enhancing innovations.

For now, you can start by looking at our senior gift lists.

• The Best Gifts for Seniors
• The Best Gifts for the Elderly in Nursing Homes

We love the idea of thoughtful and helpful house warming gifts for seniors that are making a move. Especially if this move was out of necessity. A little love and thought goes a long way with these big transitions.

Services to Keep Your Elderly Parents Safe

We all worry about falls and accidents. The elderly often experience a decline in balance and strength with each passing year. There are a few options out there of companies that will monitor your loved ones and give them the help they need in case of a fall. When we look at companies to refer you to, we look for ones with good customer service, customization options and no long-term contracts.

How can I help elderly parents with health care and insurance?

If your loved one is either older than 65 or disabled, they probably qualify for the Medicare program. In addition, if they are living on a very small income, they could also qualify for Medicaid.

From a high level view, your loved one will need to choose if they want their Medicare coverage to be bundled with a Medicare Advantage Plan or to be put together with Original Medicare, a Supplement and a Drug Plan. These are the two paths to choose from.

Let’s back up now, and break down the parts of Medicare. We want you, the caregiver, to feel as comfortable and knowledgeable as possible when helping your seniors make their decisions.

Helpful Medicare Articles for Caregivers

MedicareLifeHealth.com is a great resource for learning about Medicare. We have articles to show you how to set-up your loved one’s health care. We understand it is so important to make sure they get the coverage and care they need.

Here is where to go for more information:

• What is Medicare? (If you need to start with the basics!)
  
• What is Medicare Advantage? (The bundled option, aka Part C.)
  
• What is a Medicare Supplement Plan? (Aka Medigap or Gap Plan.)
  
• How does my loved one get a Prescription Drug Plan? (Part D as either a stand alone plan or part of a Medicare Advantage Bundled Plan.)
  
• What option is best for my loved one – Medicare Advantage or Original Medicare with a Supplement?
  
• If you have more specific Medicare Questions, we suggest reading our Medicare and You User Guide. The US government publishes a Medicare and You Book each year that goes into detail about Medicare. It is usually over 120 pages. Thus, many people are overwhelmed by it. However, it is a good resources. So we created a User Guide to help you understand Medicare better and locate the answers you need for very specific questions.

Who can I call or email for help with Medicare/Medicaid/Health Care Insurance?

MedicareLifeHealth is a national community, but health care questions and registrations are often different state to state. So, we have a couple different resources for you to work with.

If you live in Nebraska or Iowa: Your fearless leader of Medicare Life Health Co. (Carly Cummings – that’s me!) is a licensed life/health agent in NE and IA. I would be glad to help you with your questions and enrollment needs.

Please contact me here.

If you live in all other 48 States: We are building our directory of national insurance agents. Find one now:

Who should be in charge of caring for elderly parents’ finances?

There might come a time when you realize your seniors need help with their finances. As a result, you will discover two phases of caring for your elderly parents’ or grandparents’ finances:

1. Assisting with their decisions.
2. Taking over the decisions.

This same process translates to Medical decisions, so we will include information on both.

Durable Power of Attorney

When working with seniors to help them in making financial and medical decisions, you will want to set up “Durable” Power of Attorney (POA). This is a document that will give you (or someone else they trust) power to act in their place if they become mentally incapacitated.

The “Durable” part is important. Regular power of attorney documents end when a person becomes mentally incapacitated. Durable powers of attorney contracts do not. With this document, you will be able to help your elderly parent with important decisions when they cannot.

In addition, you will want to have two separate Durable Power of Attorney Documents:

1. One for Medical
2. And one for Financial.

Medical Power of Attorney (POA)

Commonly called the durable power of attorney for health care, this document names the person who will be making health care decisions for your elderly parent.

The named person will be able to enroll the elderly parent in medical plans, speak to doctors on their behalf, and represent their wishes in regards to medical care.

You will also want to make sure your loved ones have a living will and a regular will. Knowing your loved one’s desires for how end of life care and services will go is very important. Please see our full article on “Caring for Dying Parents” here.

Financial Power of Attorney (POA)

Your elderly family member will also need to name someone to carry out their financial wishes when they cannot. This is where a comprehensive durable financial power of attorney is important.

Note, this should be a separate document from the medical POA. The financial POA allows someone take over your elder’s retirement accounts, taxes, and bills. For this reason, it needs to be someone they trust, and should be done as soon as possible to make sure they are represented in the ways they wish.

Working Together

Finally, although these are two separate documents, you certainly can name the same person on both. In fact, having the same person do both will make life much easier and simpler. If you do have different people named on each document, you will want to ensure they communicate well and can work together effectively.

Where can I get support for caring for elderly parents?

I remember pulling over to the side of the road, one very stressful day, because I couldn’t see through my tears to drive. At the time, I was living with my grandparents and trying to care for them while their health continued to decline.

I was overwhelmed by the amount of work it took to keep them safe in their own home (even with the help of a home care company). Consequently, we were reaching the tipping point of needing to move them to assisted living. However, the thoughts about and process of this change were also just sad. It was a lot for me to handle.

Luckily, I had a very strong support system and access to help. You need this too. You can start by reading this article on managing caregiver stress and preventing burnout.

Find Someone to Talk to Regularly

The first step is to reach out to someone to talk to and confide in. Care-giving takes a lot out of you. As a result, you need someone to listen to you and give back to you. Whether this is a professional counselor, or just a friend, you need to make “talking it out” a priority. Better yet, make your conversations a habit or a standing date.

Seek Outside Help

The second step is to get outside help. If your parent is still at home, see what is in the budget for hiring a care service. Even if just for a few hours a week. These companies help with daily living activities for seniors wanting to still live by themselves. (This is non-medical help.)

Alternatively, you can see what social network your seniors are a part of that might want to help. My mom was excellent at getting visitors for her elderly parents from not only their friends, church member, etc. but also from her own social network. You would be amazed at how many people are willing to swing by a nursing home and say hello during the week. You just have to ask!

Set-up Self-Care

Care-giving makes you busy, tired and often plain run-down. The only way self-care happens is when you make it a priority. Moreover, you need to set it in your schedule as an important appointment.

First, create and stick to a weekly workout schedule. Then, create a routine for getting healthy meals onto your table. Finally, make sure you keep your hair appointments, massages or other healthy ways to relax and stay on top of your health.

I know it is all easier said than done, but you will be much more efficient and helpful if you are well rested and cared for first.

Action Steps for Caring for Elderly Parents

In summary, caring for elderly parents, grandparent and loved ones is a long, hard journey. However, you are not alone! In addition to all the helpful organizations, services and innovations out there, there are also real people that want to love and support you. You cannot, and should not, do this alone.

Here are a few good steps to get you started or move you forward with your loved one’s journey.

• First, if you are considering housing options, reach out to a home care service. If a move is a necessity sooner or later, start by touring one assisted living center or nursing home.
  
• Second, for seniors living at home or even in assisted living, look into a couple of medical alert systems. Falls are all too common, and you need to be prepared.
  
• Third, in regards to health care, reach out to a professional to make sure your loved one has the best coverage in their area. Plans change all the time, so a review is always a good idea.
  
• Fourth, legally, make sure you understand what your loved one needs and wants in regards to making financial decisions. Get together all the proper documents needed to secure current or future Power of Attorney options.
  
• See in your loved one has any Long-Term Care Insurance in place. Additionally, they could have a life insurance policy with a Long-Term Care Rider or a Critical Illness Rider.
  
• Finally, create a plan now for taking care of yourself and start implementing it right away. You deserve it. Thank you for taking care of your elderly parents and loved ones.
  

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I am a firm believer that there is a good Medicare health plan out there for everyone. Moreover, there might even be more than one good choice out there for your situation. If there is more than one good choice available to you, you might be weighing your options right now – Medicare Advantage vs Medicare Supplement.

First, Let’s review your Medicare options:

Original Medicare (no supplement)

Certainly, stand-alone Medicare coverage is an option. You would still want to get Part D Prescription coverage. (There are penalties down the road if you do not get Part D or have credible coverage already and then want to get it later.) However, you would then be left paying your deductibles and 20% coinsurance out-of-pocket.

For example, with ONLY Original Medicare and NO supplement or MA plan, if you ended up having a major health event like a surgery, the 20% left that medicare doesn’t pay could still be thousands of dollars.

You would also have to go through medical underwriting with a private insurance carrier if you later want a supplement and you have missed your Guaranteed Issue time frame. You can always join a MA plan later, but only during a special enrollment period or during the Annual Enrollment Period (Oct. 15 – Dec. 7).

Original Medicare with a Supplement

With this option, you keep Original Medicare and add on a Supplement (Medigap) Policy with a private insurance company to help you in paying the pieces that Medicare does not. These costs can become large if you have a big medical event or a chronic illness. In this instance, a Supplement would protect you from “losing the shirt off your back”! You would also have a stand-alone Part D Prescription Drug Plan (or a plan that is considered “credible coverage”).

Medicare Advantage (MA/MAPD)

Finally, with a MA/MAPD plan you would replace Original Medicare with a bundled plan offered by a private insurance company. These often include a Prescription Drug Plan. (These are called MAPD plans, which are most the common plans). You still “have Medicare” with these plans. However, they are run by private companies who put together networks of providers and health facilities. (For example, HMO, PPO and PFFS networks.)

One question we hear a lot is, “can I have both Medicare Advantage and a Medicare Supplement?” No, you have one or the other. Not both, they do not work together and it is illegal for anyone to sell you both.

What are the Differences Between having a Supplement (Medigap) and having Medicare Advantage (MA/MAPD)?

Now, let’s do a breakdown of Medicare Advantage vs. Medicare Supplements. First, let’s look at the difference in care and the differences in cost. We are assuming you either have Medicare Advantage or Original Medicare with a Supplement (aka Medigap Plans).

Making Your Choice between Medicare Advantage vs Medicare Supplement

Now that you understand the basics of Medicare Advantage Plans and Original Medicare plus a Medigap (Supplement) Plan and know the significant differences between the two, it’s decision time.

First, I always recommend speaking with a licensed, independent agent that can help you in assessing all the various plan types available in your area. Every county has different options for MA/MAPD plans, and insurance carriers have different prices on the supplement plans you may be considering.

Second, it’s good to have an idea of what is important to you. You should be thinking specifically in regards to money and lifestyle when choosing a path.

Consider these questions when choosing between Medigap and MA Plans:

Do you plan on living in another place for a significant period of time during the year?

If you are a “snowbird” or are planning a longer vacation where a routine doctor visit may be necessary when away from your primary residence, then a supplement may be your best choice. Remember though, emergency / urgent care visits are covered with both types of plans.

However, if your travel happens to be international, Both Original Medicare and MA plans do not cover foreign travel, but some supplement plans (plans C, D, F, G, M & N) have 80% foreign travel exchange limits that will help off-set some costs.

What is (or will be) your cash flow situation in retirement?

Some retirees have pensions, social security and other payments (like annuities) that come to them automatically each month. Other retirees have less of these automatic infusions or smaller required distributions and prefer to leave as much of their cash in investments as possible. Finally, some retirees are on a smaller, fixed income. This might require them to consider cash flow very carefully.

In each situation, you will need to review how you are paying for your health services, as each plan offers different payment options.

Cash Flow with a Supplement:

With a supplement, you will have a set amount of money (that could be a larger sum than an MA plan) come out of your bank (and/or S.S./R.R. check) each month. This can add up when you consider it includes Part B premiums, Part D Prescription premiums, and your supplement premiums. However, if you chose a plan that covers everything Original Medicare leaves out, then you would not pay any other out-of-pocket fees for Medicare covered services.

Cash Flow with a MA/MAPD Plan:

With a Medicare Advantage plan, you will most likely have a smaller amount of money coming out of your wallet each month. You will most likely have an MAPD plan that includes your drug plan, as stand alone MA plans are becoming much more rare, and some plans even include Part B premiums. So, with a MAPD plan, you would be paying a MA premium and maybe your Part B premium each month. Moreover, there are sometimes zero dollar per month ($0/month) premium MA plans available. The costs then to consider and maybe budget for with MA plans is if there are any co-pays, co-insurances and deductibles with the plans. Each plan will be set-up differently, and each plan will also have a max yearly out-of-pocket limit.

Just like in any kind of insurance, Medicare plans are set-up to allow you to choose how much out-of-pocket expenses you incur versus monthly premiums you pay.

Looking at your budget and then talking through your options with a licensed agent will allow you to make the best choice for your situation.

How interested are you in extra benefits being included?

Finally, one more consideration is the other elements that round out your health insurance plan, such as dental, vision, hearing, etc. If you have a supplement plan, you will need to decide if you need these services, and if you do, are you wanting to take on insurance plans for them. You might decide to add on a stand-alone, or a plan that includes any or all of these common services (dental, vision, hearing).

Often times, Medicare Advantage plans will include these services as a part of their plan as an additional benefit which might save you money if you were planning on getting a stand alone plan or paying cash for these services.

Moreover, many MA plans will offer fitness or wellness services that are included at no additional cost. Sometimes this means you will not have to pay for a separate gym membership. Silver Sneakers is one example of a national program that is used by many MA plans to provide fitness and wellness services.

The Next Steps for Choosing Your Medicare Plan

As you can see, developing your Medicare Health Insurance Plan can be very involved, but I am confident you can do it! Having a professional to help you through the process is important. Please reach out to an independent insurance agent to review what is available in your area. They will be able to explain plans in specifics and answer your questions about Medicare Advantage vs Medicare Supplement.

Finally, Medicare.gov is also a good tool for answering your broader questions, and we also encourage you to comment on this page or contact us directly with any questions. Thanks!

Other Topics Related to Medicare Choices:

• Medicare Supplement Basics
• Medicare Advantage Basics
• Prescription Drug Plan Basics

The post Medicare Advantage vs Medicare Supplement appeared first on Medicare Life Health.

In this article, we look at what is Medicare Advantage (aka Medicare Part C). As we discussed in our Medicare 101 Post, there are two different Medicare paths. You will choose one when you are setting up your health care in retirement.

• Path One = Original Medicare, Part A and Part B, with a stand alone Prescription Drug Plan (Part D) and an optional Medigap (Medicare Supplement) Plan.

• Path Two = Medicare Advantage (Part C) that replaces Medicare Part A and Part B and typcially includes a Part D Drug Plan. These plans are offered by private insurance companies that you work with directly.

The Basics of Medicare Advantage

Medicare Advantage “bundled” plans are offered by private insurance companies (carriers). You use them IN PLACE of Original Medicare, but they are still Medicare. Moreover, they must include all the same Medicare services covered by Part A (hospital) and Part B (medical). In addition, almost of them include Part D (prescription drugs).

You will hear/see these plans referred to as MA plans, and MAPD plans when they include prescription drugs.

What is the Advantage to Choosing a MA or MAPD plan?

The first advantage to these plans is that many of them have lower out-of-pocket costs than Original Medicare. Secondly, they often have extra benefits such as dental, vision or hearing that is not included in Medicare.

What are the Costs of a MA / MAPD Plan?

First, remember that most people have Medicare Part A “premium free”. (See this page on the medicare.gov website if you are wondering if you are in the “most people” category.) Second, remember that most people also pay a monthly premium for Part B. However, some Medicare Advantage plans will pay all or part of your Part B premium.

There may be many (or just a few) different MA and MAPD plans available in your area. They will all be set up differently and cost different prices from carrier to carrier. We suggest finding an independent insurance agent/broker that can compare different plans, carriers (insurance companies) and prices. They will help you pick a plan that fits your lifestyle and financial needs. Please note, there are often plans out there that have low or even $0 monthly premiums.

In addition to whether or not you pay a monthly premium with a MAPD plan, each plan will have a different set up for out-of-pocket costs:

• Some plans have a yearly deductible.
• Other plans have co-pays for office visits.
• Some plans have out-of-network costs
• And some plans have yearly max out-of-pocket limits.
  See this medicare.gov page for more info on MA costs.

You will need to decide what plans fit well with your monthly cash flow situation in addition to how often you need medical products and services.

How do MA and MAPD Plans Work?

Insurance companies usually set-up Medicare Advantage programs as a PPO or HMO networks. You might be familiar with this style of network plan insurance if you had (have) one from an employer or even from the open marketplace.

Typically, you will need to use doctors in your MA plans network. (Unless it is an emergency, or unless you are willing to pay extra to go “out-of-network”). If you have providers you want to keep, ask them if they are part of a network you are considering. In some MA/MAPD plans, you may also need referrals to see specialists. These are all plan specific requirements. You will need to look all these requirements prior to making your MA decisions.

HMO and PPO plans have much more robust networks now than plans from the past. Most people can find a plan that is large enough/flexible enough to work with their lifestyle. This is true even if they travel frequently in retirement. I recommend talking to a licensed agent to make sure you understand how the plans work.

When Can You Sign-up for a Medicare Advantage Plan?

If you are a US citizen with both Part A and Part B Medicare coverage, you can join MA plans in your area during these times:

• During your Initial Enrollment Period (IEP): Just like joining Original Medicare, you can join a MA plan during the 7 month period (3 months before the effective date of Medicare Part A and B, including the month Medicare begins, and then 3 months after) of time that you are turning 65.

• During a Special Enrollment Period (SEP): There are special circumstances that give you the opportunity to enroll in a MA/MAPD plan. These include (but are not limited to) moving to a new county, losing group health (like from an employer), or managing a chronic illness. To learn more about SEP’s and their time frames, please visit this page on the government’s website.

• During the Annual Enrollment Period (AEP): October 15th to December 7th, is when you have the opportunity each year to join an MA/MAPD plan. Your new coverage will begin January 1st.
  
  *OEP – As of 2019, if you are already in a Medicare Advanage plan, you can also change plans during AEP, or you can switch plans once (or switch back to Original Medicare) during Open Enrollment Period – January 1st to March 31st.

Other things the US Government would like you to know about MA Plans:

• Emergency and Urgent Care is always covered with MA plans.
• MA plans cover all Original Medicare Services and carriers must follow all Medicare rules.
• MA plans may have extra benefits like vision, health, dental and other fitness/wellness programs.
• You can join a MA plan with pre-existing conditions (except for ESRD, which is a special case and has other options).

Who can Help You with a Medicare Advantage Policy?

Just like a supplement, you can compare these plans online, but I suggest you talk to a professional, independent insurance broker that can help you compare plans. It won’t cost you any more money to use a professional, and Medicare Advantage Plans can be overwhelming when you are trying to pick one, especially if there are many offered in your area.

Remember, independent agents work for you (not the carriers), and having an actual person to help you in communicating to insurance carriers and keeping you updated each year is very valuable. This is something you do not get if you sign-up directly with a company online.

If you are in the state of Nebraska and you are looking for an agent to help you in any area of Medicare, Health or Life Insurance, please get in touch with me here.

Where to go next:

• Medicare Supplements vs. Medicare Advantage – What is right for you?
• What are Medicare Supplements?

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