A Caregivers Guide to Navigating Government AgenciesFeb 23, 2023
A Caregiver’s Guide to Navigating Government Agencies
By: Generationally Prepared
Fully supporting a Senior as a caregiver requires a holistic approach to their finances and assets, including medical bills. From financial institutions to day-to-day expenses, all aspects of their portfolio and support systems must be accounted for and managed so that when a change to your Senior’s life happens—from different medical needs to housing—the transition is as smooth as possible. It’s also important to take advantage of any services available that you may not know about! As a part of a caregiver’s plan, government agencies can be a critical piece to your Senior’s wellbeing. Social Security, Medicare, Medicaid, and VA Benefits are all a tool for you to help direct finances and medical decisions for your loved one. With millions of Americans each year using these services, odds are your Senior uses one of these four programs—if not more. This guide is an introduction into how you can step into the role as caregiver for your Senior within each institution’s regulations and specifications for how you can be a recognized manager of their accounts.
Around 66 million Americans take advantage of Social Security benefits each month, and as such, the government has a specific process for caregivers to be able to access their loved one’s information and resources. As opposed to other institutions on this list, Social Security has an entire program dedicated to finding responsible managers for people who can’t oversee their own SSI (Supplemental Security Income) payments anymore. Called the Representative Payee Program, Social Security prefers to find family or friends to serve as payees. They also offer the opportunity to advance designate payees in the event of a sudden illness or incapacitating event. It’s important to keep records of expenses, as Social Security will request a report of how the assets went to paying for the beneficiary’s needs.
To apply to become a representative payee, you must visit a local Social Security office and provide your loved one’s information, including Social Security number, as well as verification documents (such as a legal photo ID) of yourself to be able to sign form SSA-11, which designates you as the representative payee of your Senior. It’s important to note that the Treasury Department does not recognize Power of Attorney in the event of your Senior being incapacitated; to take control of their payments one must go through the Representative Payee Program. The responsibilities for a representative payee are outlined on Social Security’s website here and include filling out an annual report and being accountable for the proper spending of funds, as well as updating Social Security on the condition of your Senior and if there are any changes. The annual report is mailed directly to you once per year but is also available at your local office or by phone call at 1-800-772-1213.
Social Security provides an extensive guide located on their website on all the duties and specifics for representative payees. It’s worth noting that in the event of your loved one transitioning on, you may be eligible for survivor’s benefits depending on the relationship and age of your Senior. The notification of your Senior’s passing usually comes from the funeral director but can also be called in to Social Security directly.
Medicare, the federal health insurance for Americans 65 years and older, is a useful mechanism for reducing costs and helping medical care become more affordable as your Senior grows older. As a caregiver, the process for taking the reigns over your Senior’s medical decisions and information is relatively straightforward within the government program. Like Social Security, Medicare doesn’t recognize a power of attorney alone to be able to access your loved one’s information. While a durable power of attorney is crucial to navigating the medical process for a loved one at the hospital, Medicare requires a specific form, form CMS 10106, to be able to talk to providers and Medicare assistance. One way to have someone authorized to manage your account is for the beneficiary—your Senior—to call in and give authority over the phone—the number is 1-800-633-4227.
The main form, the Medicare Authorization to Disclose Personal Health Information, (form CMS 10106) available on their website here, permits you as the caregiver to access your Senior’s information and help make Medicare-related decisions on their account. It has the options for limited and full access, as well as optional lengths of time for the supervisory period. You can mail in the form (the mailing address is listed on the document) or you can also log in to MyMedicare.gov to submit the information online. If you need help submitting any forms, SHIP (State Health Insurance Assistance Program) can be a resource to understanding different Medicare requirements. If your loved one needs assistance with only one appeal, they can fill out the Appointment of a Representative form located here.
If your Senior isn’t able to fill out the Medicare Authorization to Disclose Personal Health Information paperwork, contact Social Security to use the Representative Payee Program to access your loved one’s information. Medicare can use this credential as recognition that you are a responsible individual acting in your Senior’s best interest.
Medicaid, a support for low-income Americans in their payment of healthcare costs, isn’t distributed at the federal level, but is unique to each state. As such, the requirements of Medicaid in taking charge of your Senior’s accounts fluctuate depending on the territory you reside in. However, to make determinations over your Senior’s healthcare decisions within Medicaid, a durable power of attorney (a power of attorney that remains active even if your loved one is incapacitated) is crucial to being the responsible agent. To gain access to the resources available to your state, Medicaid can require a number of documents—such as financial statements and proof of life insurance—that need a Power of Attorney to be able to access. It may also be helpful to retain the abilities of a Medicaid Planner in order to negotiate various Medicaid requirements, though to be able to do this, a durable power of attorney is necessary. To find your state’s requirements to become the responsible agent over your senior, contact Medicaid at 877-267-2323 to be put in touch with your local office.
The office of Veteran’s Affairs also has programs that could apply to your Senior if they served in our nation’s military. Since power of attorney only applies to the state level, the VA requires some supporting documentation to act as your loved one’s agent. VA benefits are extensive, and to access your Senior’s information, form 21-0845 (Authorization to Disclose Personal Information to a Third Party) allows the VA to communicate with you directly to handle your Veteran’s information. Found here, it can be submitted by mailing address (available on the form) or by submitting it online. This form allows customization of what information is released and the time lengths for the disclosure.
In order to make healthcare-related decisions, form 10-0137 (VA Advance Directive: Durable Power of Attorney for Health Care and Living Will) is required, and is available on the VA office’s website here. This allows for you as a caregiver to determine medical treatment for your loved one in case they’re no longer able to do so on their own. If your veteran is incapacitated and is unable to sign or fill out the forms, document 21-0972 (Alternate Signer Certification) is necessary to be able to verify the paperwork in your Senior’s stead. Also available publicly on the website, it can be submitted in the same way as the previous forms, online or per the mailing address on the document. You may need to provide a power of attorney upon request as supporting evidence to be your Senior’s agent. If you need assistance filling out information or have general questions for the VA’s office, you can contact them here, or by phone at 1-800-827-1000.
While there are different procedures in place for government institutions, gaining access to your Senior’s information is crucial to manage personal finances and to make informed decisions on behalf of your loved one, medically or otherwise. Generally, a power of attorney or a court-approved guardianship, while useful in sustaining a holistic support system for your Senior, isn’t enough for Federal programs. Though we’ve outlined the specific documentation you may need for institutions like Social Security and VA benefits, Medicaid has state-specific functions that will require having a durable power of attorney in the event of your loved one being incapable of filling out forms themselves. To be prepared as a caregiver, we’ve contacted each program to find out what you may need to gain access to your Senior’s accounts. With the proper preparation, your Senior can take advantage of these government programs without unnecessary difficulty!