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Managing Medical Conditions with MedicareAs your parents, grandparents, relatives, or friends face health care decisions, they may need help in Managing Medical Conditions with Medicare. Medicare can be an important factor in many of those health care decisions. It is important to understand the role Medicare can play in planning for medical care, managing chronic illness and hospitalization, and paying for medical expenses.






In This Managing Medical Conditions with Medicare Article:

Planning for medical care
Information needed for medical planning
State Health Insurance Assistance Program


Planning for medical care

If you find that an older relative or friend needs your help to deal with a medical condition, there are a number of steps you can take to help in managing medical conditions with Medicare.

1. Begin by talking with the person and other family members about medical and prescription drug needs, as well as about who should have permission to act on the person’s behalf.

2. Find out what kind of health coverage the person already has. If the person has Medicare, find out which parts: Medicare Part A (hospital insurance), Part B (medical insurance), or Part D (prescription drug coverage). Also, find out whether the person is in Original Medicare, in a Medicare Advantage Plan (like an HMO or PPO), or in any other type of Medicare health plan. This information is on the person’s Medicare card.

3. If the Medicare card for the person you care for is not available for you to look at, you can either call Medicare together, or the person can complete an authorization form to allow you to get Medicare information released to you. To get an authorization form, call Medicare at 1-800-Medicare (1-800-633-4227). TTY users should call 1-877-486-2048. If the person does not currently have Medicare, find out when he or she will be eligible to enroll.

4. It is also important to find out if the person has other health coverage in addition to Medicare, such as a health plan with a former employer, Medicaid, or other insurance that can help pay for health care needs. If the person is enrolled in Original Medicare, also find out if he or she has a Medigap (Medicare Supplement Insurance) policy.


Information needed for medical planning

As you work together to plan for medical care, it will be helpful to have the following information about the person:

    • Social Security number
    • Medicare number and Medicare plan
    • Other insurance plans and policy numbers, including long-term care insurance
    • Contact information for health care professionals, including doctors, specialists, nurses, pharmacists
    • Current list of prescription and over-the-counter drugs, herbal remedies, and their dosages
    • Current health conditions, treatments, and symptoms
    • Hstory of any past health problems
    • Any allergies or food restrictions
    • •Emergency contacts, close friends, neighbors, clergy, housing manager
    • Where to find financial and legal information, including the person’s living will and medical power of attorney


State Health Insurance Assistance Program (SHIP)

When you have a Medicare concern that needs to be discussed, a good resource is the State Health Insurance Assistance Program, or SHIP. SHIP gives free health insurance counseling and guidance to people with Medicare or to family and friends, like you, who have authorization to help someone with Medicare questions. (In some states, SHIP is known as SHIBA or SHINE.)

The counselors at the SHIP office can answer general questions about hospitalization, Medicare choices, and local programs that can offer additional help. They can also help you learn more about living wills and power of attorney procedures.

You can meet with a local representative or talk to a SHIP counselor on the telephone for personal assistance. To get the most up-to-date telephone numbers, call 1-800-Medicare (1-800-633-4227) or visit www.medicare.gov (TTY users should call 1-877-486-2048.) Under “Search Tools” select “Find Helpful Phone Numbers and Websites.”


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