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Jul 20, 2015 by |

Understanding Medicare for Caregivers


This year is the 50th anniversary of the Medicare program, and caregivers often find navigating Medicare and Medicaid to be one of the most difficult parts of managing a loved one’s finances and healthcare. San Francisco elder abuse attorneys emphasize that caregivers should know the basics and major issues involved with Medicare.

Medicare is for people 65 years and older, or those under 65 who have long-term disabilities or end-stage renal disease. There are various types of Medicare. Medicare Part A is hospital insurance, but can also include skilled nursing, hospice, and some aspects of home healthcare. Medicare Part B is medical insurance, which covers doctors’ visits, tests, shots, and other parts of home healthcare. Part C is also called Medicare Advantage, and is run by private insurance companies. Part D is prescription drug insurance.

Medicare has monthly premiums, deductibles, and copays. Premiums for Part B are automatically deducted from Social Security, Railroad Retirement Board, or other civil servant benefits. Those who do not receive these benefits receive a monthly bill. There are also savings programs available to help pay for premiums, which your State Health Insurance Program or Social Security office can assist with. For those with limited assets and income, Medicare Part D “Extra Help” can also help pay for premiums, deductibles, and copays.

There is also “Medigap” insurance, which is supplemental insurance that can cover all or part of out-of-pocket expenses, and is available from private insurance companies.

It is important for caregivers to know what Medicare will cover with certain key coverage areas. For skilled home health services, care can be covered if a loved one is homebound and the doctor has ordered it, but usually only for a limited period of time. It usually follows hospitalization, and must be done through a Medicare-certified agency. Medicare will pay for a home health aide to assist with personal care if they qualify for skilled home health services, and only during the period they are receiving these services. Otherwise, personal care is not covered.

Medicare pays for skilled nursing facilities only when certain qualifications are met, such as following an inpatient stay in a hospital, and only for a limited time. Medicare does pay for hospice care in the home or an inpatient facility. It also pays for certain medical supplies and equipment when provided by a Medicare-certified home health agency.

Those who are denied coverage by Medicare can appeal, or a loved one who has power of attorney can appeal on their behalf. San Francisco elder abuse attorneys say that there is usually a time limit on appeals, so they should be filed as soon as possible.

Evans Law Firm, Inc. handles Medicare fraud cases, as well as elder abuse lawsuits, including caregiver abuse. If you or a loved one has been a victim of elder abuse, please contact Evans Law Firm, Inc. at 415-441-8669 or via email at

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