Caregivers of retirees are unsung heroes. Whether it’s a spouse, child, in-home health professional, or other individual, caregivers undertake a myriad of important daily responsibilities. They handle tasks that most of us take for granted and typically do so while working a full-time job and/or caring for other family members.
The concept of aging at home continues to gain significant traction. Older adults prefer to maintain their independence and live in familiar surroundings. The COVID-19 pandemic exacerbated the demand for in-home care and led to workforce shortages in professional caregivers, resulting in family members taking on greater responsibility as primary caregivers.
This arrangement can be extremely challenging for family caregivers because, while they typically perform roles related to personal care (such as meal prep, medication dosing, grooming, and transportation), they can get overwhelmed with navigating complex care systems and health insurance plans. A misunderstanding of the complete suite of healthcare benefits available to an older adult/retiree can result in the underutilization or misuse of these benefits, ultimately diminishing the quality and value of care.
The need to support caregivers in effective navigation of long-term care services – the “administrative” side of caregiving – is critical.
Beyond Personal Care: The Administrative Role of the Caregiver
Most of us aren’t aware of the many administrative responsibilities that caregivers undertake, which extend well beyond their personal caregiving role and can be extremely time-consuming. Here’s a sampling:
- Calling carriers with questions regarding benefits coverage
- Obtaining prior authorizations from insurance carriers for provider appointments
- Scheduling provider appointments and follow-up appointments with specialists
- Filling and refilling prescriptions
- Arranging for pick-up or mailing of prescriptions
- Procuring durable medical equipment — wheelchairs, adjustable hospital beds, ventilators, and more
- Procuring skilled nurses and communicating with them daily
- Resolving coverage and billing issues with providers, pharmacies, carriers, and other entities
How Our Retiree Advocacy Services Help Caregivers
Our Advocates have gained the trust of our retirees, and as they do with retirees, Advocates help caregivers navigate the complexities of retirees’ Medicare plans, on multiple fronts. Our Advocates handle over 2,000 calls per day, and approximately 10% of those are from caregivers of retirees. The following graphic highlights the top reasons why caregivers call RetireeFirst, shown as a percentage of total caregiver calls:
Don’t Overlook Administration Support for Retirees
For example, Advocates assist caregivers in obtaining prior authorizations, streamlining the process and ensuring timely approvals. They help caregivers arrange mail-order services for retiree medications, enhancing convenience. They proactively contact providers on behalf of caregivers to ensure that providers are well-informed about the retiree’s plan – resulting in the best care outcomes and minimizing coverage-related questions.
When caregivers are exasperated with challenges that arise, such as issues regarding drug coverage or billing, our Advocates call pharmacies, providers, or other entities to ensure successful resolution, alleviating caregiver frustration and stress and freeing them to focus on personal care-related tasks.
One of our retiree caregiver representatives recently encountered multiple billing issues with a health system. After her Advocate stepped in to resolve the issue, the caregiver stated, “My Advocate called the billing department of this large health system, and she resolved my billing issues. Everything is squared away, cleaned up, and over with. My Advocate has made such a difference. She takes the pressure off me because I speak to her every time, and she always handles the issues and calls to tell me everything’s been fixed. She’s always pleasant and upbeat. She’s a lifesaver and godsend.”
Additionally, there are numerous carrier-sponsored programs of which retirees and caregivers are often unaware. Through our Gaps in Care program, our Wellness Advocates proactively contact caregivers to schedule critical medical appointments for retirees, including screenings, vaccinations, diabetic eye exams, and more. They also coordinate House Calls, where medical professionals conduct in-home visits and other vendors perform home safety assessments, such as railing and flooring stability, alarm checks, and other important measures. Our Gaps in Care program ensures that caregivers are maximizing utilization of their retired loved ones’ healthcare plans.
RetireeFirst stands as a dedicated partner to caregivers, recognizing their invaluable role in retirees’ lives. Please contact us to learn more about caregiver support.
Contact Us to Learn How RetireeFirst Can Help
