Welcome to Molina Caregiving for Medicare

Hear from Molina Healthcare medical directors and nurse practitioners about caregiving and caregivers:

What is caregiving?

Caregiving is the act of giving care to someone to keep them safe and healthy in their home. A well-prepared caregiver will reduce stress for all including the person getting care.

Giving and Receiving Care

Deciding when a member needs caregiving Deciding when a member needs caregiving

A caregiver is someone who gives care to a person for many reasons. There are caregivers who come from agencies, but most caregivers can be anyone from a family member to a friend or a neighbor. The main reason for caregiving is to keep a person safe and healthy in their home.

Caregiving needs can be both planned and unplanned.

Unplanned caregiving needs can arise in times of:

  • An unexpected surgery
  • An unexpected medical issue such as a stroke
  • An accident

Planned caregiving can occur if the medical issue or surgery is known in advance. In the most common cases, caregivers are needed to manage long-term illnesses or to support those who simply cannot manage some part of their daily needs without help. For members, many often want to age-in-place in their own home. Having a part-time or full-time caregiver can help them.

These duties do not have to rely on one single caregiver. If possible, a caregiving team can share the duties where it makes sense. See the section on becoming a caregiver to learn more.

Your doctor can help you identify your caregiving needs.

How to become a caregiver How to become a caregiver

Being a caregiver

Caregivers can be a family member, friend or neighbor. Many people start out as a helper until the member’s needs grow. Take time to plan as there are many things to think over. The main goal is to keep a member healthy and safe in their own home.

What type of care is needed?

The amount and type of caregiving depends on where members need the most help. Sometimes the support is needed for personal Activities of Daily Living (ADL) like:

  • Bathing and toileting
  • Dressing and grooming
  • Making sure a member takes the right medicines on time
  • Creating basic safety measures in the home

Sometimes the member needs more help with things that are less personal, such as:

  • Driving to doctor visits
  • Shopping for groceries or cooking meals
  • Helping with household chores
These are called Instrumental Activities for Daily Living (IADL)

ADL and IADL and are some duties of caregiving. When you become a caregiver, think about the needs of the person you are caring for such as:

  • Does the member have any allergies or rules about food?
  • Is the member’s home set up for moving safely around the home? What needs to be changed to make it safer?
  • Does the member need medical supplies? How would they get them?


Levels of Caregiving

Sometimes caregivers need to do more than helping a member with private or home tasks. In some cases, the caregiver needs to know the member’s benefits. In other cases, the caregiver may need the member’s approval to make healthcare choices.

The need to get answers to questions on the member’s behalf may involve Protected Health Information (PHI). This calls for certain consent and signed forms. Some examples of these forms are listed below:

  • Verbal Consent (Up to 14 days only): This is given by the member who has the capacity to do so. It can be done in person or over the phone and must be done by the member. This lets the caregiver get information about the member that is relevant to the caregiver’s involvement. It does not allow the caregiver to make any changes.
  • Protected Health Information from HIPAA: (PHI) The member or their Personal Representative can complete this form. This lets Molina share PHI but does not require them to do so.
  • Appointment of Representative Form (CMS-1696) – An appointed representative is a family member, friend, doctor, or other person. They are approved to act on your behalf in filing a grievance, coverage determination or appeal. This form is for Medicare members.
  • Durable Medical Power of Attorney (POA): This document is used if a member needs some other person to make a healthcare decision. This happens when the member cannot make that decision for themselves. The form giving Medical POA comes from your state. The signed Medical POA makes a person the Personal Representative to the member as stated by HIPAA rules. Forms for this type of POA are different for each state. You can find the right form by going to the bottom of this page and choosing your state. This will take you to the page on your Molina Healthcare website that has the link to the state form.
    • Note: This is different from an advance directive (AD). An AD makes clear a member’s medical wishes but does not appoint a person to make healthcare choices.
This information does not, and is not intended to, constitute legal advice. Readers of this information should talk to an attorney to get advice with respect to any legal matter.

Important caregiving tips Important caregiving tips

Caregiving things to think about

A caregiver must learn the amount of time that is needed for the person getting each type of care. Some caregivers are needed to help someone get better from surgery or sickness. Others will need to be on hand for much longer to manage a disability or to keep the member safe in their home as they get older. Some other questions to keep in mind are:

  • Is this a daily check-in or full-time care?
  • Is there another person else that can help you?
  • Do you live close by or far away? Can you react quickly to an emergency?
  • How will you balance caregiving with your job? Or will this be your full-time job?
  • Will you need to spend your own money on items for the member?

Talking about the need for care

Talking about starting caregiving can be hard. Some people may feel that they are losing their freedom. Others may not want to ask for help. Here are some tips to help:

  • Planning what you want to say, but be ready to change
  • Making the member feel at ease in a quiet setting
  • Being patient and talking about their concerns
  • Keeping it positive and reminding the member that caregiving keeps them safe and healthy

Caregiver benefits

Caregiver support may be available to those who have Medicare Advantage or who have both Medicare and Medicaid, also known as D-SNP (Dual Eligible – Special Needs Plan). Check the member’s Summary of Benefits to see what kind of coverage they have, or if you do not know, contact us to learn more.

Some plans may also offer respite benefits for the caregiver. This lets the caregiver be able to take time away and provides a trained caregiver for the member. If you have specific benefit questions, contact Member Services using the number on the back of the member’s ID card. To find local caregiving resources, go to the bottom of this page and select your state.

Taking care of the caregiver Taking care of the caregiver

Taking care of the caregiver

Caring for an adult who needs support can be very rewarding, but it can also be challenging. Caregivers can forget to take care of themselves. Many people become stressed and find it hard to balance caregiving with their own lives.

Here are some tips for you to stay healthy:

Take time for yourself: Self-care is important! Take time to maintain a healthy diet, get enough rest, and attend to your own needs. Keep a balance between your life and the person receiving care. Take breaks and attend to your own health. Spend time with friends or family to talk or just be around each other. You are a caregiver to both yourself and the other person.

Remind yourself of the positives: Choosing to become a caregiver is not an easy decision, but it is an important one.

  • Try not to lose sight of what you value in the person you are caring for.
  • Maintain a positive attitude and cherish the time you get to spend with this person.
  • If you feel your responsibilities are taking up too much of your time, consider making a caregiving team to share duties.

Understand you cannot control everything: A member’s caregiving needs can change over time even with a good plan in place. Remember that you can only control certain things, and you must adapt to unexpected changes.

  • Stay flexible and try not to get down on yourself or the member when things do not go according to plan.
  • Adjust your caregiving plan and checklist as things change.
  • Care Connections Nurse Practitioners, and our Concierge Member Services can all assist you or the member.

Seek outside resources: You are not alone. If you see a decline in your own health, reach out to an expert. Your own insurance plan may offer mental health benefits. Here are some other things you can do to get more information and support:

  • Some Molina Healthcare plans may offer support or financial aid for the caregiver. More information can be found in the member’s Summary of Benefits or by calling Member Services at the number on the back of the member’s ID card. Remember, you must return the right forms to be approved to discuss a member’s benefits. You can find more information about levels of caregiving and the right forms in the How to become a caregiver section above.
  • Ask for help from friends or family members if you need it. They may need the time with you as well.
  • If you are interested in local resources to help you on your caregiving journey, you go to MolinaHealthcare.com and selecting your state from the menu. Or visit the bottom of MolinaCaregiving.com and select your state.

Helping you so you can help others

 

Select your state below to find additional local resources
and links to other important forms