Caregivers

A Caregiver's Guide to Medicare in Washington

If you help a parent, spouse or other family member with Medicare in Washington, start by getting written permission to speak for them, then use Washington's own programs for the care Medicare doesn't cover: Community Living Connections, Apple Health long-term care, and the WA Cares Fund, which began paying benefits on July 1, 2026.

By the Benefits Life Editorial Team, licensed insurance agents · Reviewed November 9, 2026

The first calls to make

Start with Community Living Connections at 1-855-567-0252, Washington's statewide network for aging and disability services. Through your local Area Agency on Aging, it can help with long-term care planning, in-home services, caregiver support and applications for public programs. More on CLC →

For Medicare coverage questions, call 1-800-MEDICARE (1-800-633-4227) with your family member on the line, or use Medicare.gov. For help comparing Medicare plans, a licensed insurance agent with Benefits Life can talk with you and your family member together, at no cost to you, about plans from the companies they work with. Call (206) SENIORS (206-736-4677), TTY 711.

Authority to act on someone else's behalf

You can't make Medicare decisions for another adult unless you have written authority. Here are the levels that matter:

Permission to share information (Medicare)

The simplest level. Your family member can fill out Medicare's "Authorization to Disclose Personal Health Information" form (CMS-10106), online or on paper, to let Medicare talk with you about their claims and coverage. They can also give verbal permission while you are both on a call with 1-800-MEDICARE. Medicare plans have their own forms, so ask each plan too.

Appointing a representative (SSA-1696 and CMS-1696)

Form SSA-1696 lets your family member appoint you to act for them with Social Security, for example on a Part B enrollment question or a premium (IRMAA) appeal. For a Medicare claim appeal, Medicare uses its own form, CMS-1696. Both you and your family member sign.

Power of attorney

A durable power of attorney lets you act for another person on financial and legal matters, and Washington's form follows the Uniform Power of Attorney Act (chapter 11.125 RCW). Social Security does not accept a power of attorney as authority to manage benefits; it uses representative payees for that, and its own forms for representatives. Ask Social Security and each plan what they need before an urgent decision comes up.

Health care power of attorney and health care directive

For medical decisions. A durable power of attorney for health care names someone to make health care decisions if the person can't, and a health care directive (living will) records their wishes about life-sustaining treatment. More on advance directives →

Guardianship and conservatorship

The most restrictive option: court-ordered authority to make decisions for someone who can't make them. Under Washington's Uniform Guardianship Act (chapter 11.130 RCW), courts consider less restrictive alternatives first.

Get the paperwork done early. The worst time to set up authority is during a medical or insurance crisis.

Helping someone enroll in Medicare

If they're approaching 65

Help them gather:

Social Security number
Birth certificate or other proof of age
Work history (they can see it in a my Social Security account at ssa.gov/myaccount)
Information about any current health insurance, especially coverage from a job
A list of current prescriptions with dosages
A list of doctors they want to keep

Then enroll online at ssa.gov, by phone at 1-800-772-1213, or at a Washington Social Security office. More on turning 65 in Washington →

If they're already on Medicare and need to review or change plans

Open Enrollment (October 15 – December 7) is when most plan changes happen. A plan:

Read their Annual Notice of Change. Medicare Advantage and Part D plans send it each fall; it lists the plan's changes for next year.
Check whether their plan is ending. Many Washington Medicare Advantage plans end on December 31, 2026. See Washington plans ending in 2027 for the deadlines.
Check that their doctors are still in the network. Networks can change every year.
Check that their medications are still covered. Formularies change every year.
Use Medicare.gov's Plan Finder with their actual prescriptions and pharmacies.
Or get help from a licensed insurance agent with Benefits Life ((206) SENIORS (206-736-4677), TTY 711), or see plans in your ZIP code.

What to look for as a caregiver

Signs of cognitive decline that affect Medicare decisions

Untreated cognitive decline can lead to missed enrollment deadlines, coverage that doesn't fit, uncovered medications and fraud. Watch for:

Confusion about the difference between Medicare and Medicaid
Unopened envelopes from Medicare or insurance plans
Medical bills they don't remember
Strangers calling about their Medicare card or "verifying" their Medicare number
Trouble refilling prescriptions on time

Medicare fraud aimed at older adults

Common scams:

Calls offering medical equipment or genetic testing at no cost in exchange for a Medicare number
Uninvited visits to the door to sell Medicare plans; Medicare's marketing rules don't allow plans or agents to come to your door without an appointment
"Medicare card replacement" calls asking for the number
Bills for services or equipment never received

Report suspected fraud to 1-800-MEDICARE or to the Senior Medicare Patrol, which you can find at smpresource.org. See our fraud prevention guide.

If you live in another state

You can still help a Washington family member from afar:

Get written authorization first, so Medicare and the plan can talk with you, and use three-way calls with your family member on the line
Ask each plan how to be listed as an authorized contact and whether it offers online account access for caregivers
Arrange for mail so the Annual Notice of Change and other plan letters reach you in time to act
Plan a yearly review before Open Enrollment (October 15 – December 7)
Call Community Living Connections for services where your family member lives

Long-term care planning

Many people eventually need help with daily activities such as bathing, dressing, meals and getting around. Medicare does not cover this kind of ongoing custodial care. Washington options:

WA Cares Fund: Washington's state long-term care benefit, paying benefits since July 1, 2026, for people who contributed long enough and need help with at least three daily activities. See WA Cares details.
Apple Health long-term care: Washington's Medicaid can pay for nursing facility care and in-home and community care for people who meet its financial and functional rules. More on Apple Health.
Community Living Connections (1-855-567-0252): the starting point for in-home services, adult day programs, respite and residential care options.
Senior centers in many Washington communities offer meals, activities and other services.
PACE (Program of All-Inclusive Care for the Elderly): available in some parts of Washington through DSHS; combines Medicare and Apple Health coverage with in-home and adult day services for people 55 and older who need a nursing-home level of care.

Support for you, the caregiver

Caregiver burnout is real. Washington resources for caregivers:

Family Caregiver Support Program, through your local Area Agency on Aging (reach it through Community Living Connections)
Respite care: short-term care for your family member so you can rest, available through some programs or paid privately; Medicare hospice also covers short inpatient respite stays
Medicaid Alternative Care (MAC) and Tailored Supports for Older Adults (TSOA): Apple Health programs that support unpaid caregivers of people 55 and older with respite, supplies, training and more. HCA says both paused new enrollment and started a waitlist on December 1, 2025.
Dementia resources from DSHS and the state's Dementia Action Collaborative
Washington 211: dial 211 or visit wa211.org for community resources

Washington help: quick reference

Community Living Connections, aging and long-term care services: 1-855-567-0252
1-800-MEDICARE, the federal Medicare helpline: 1-800-633-4227
Social Security, enrollment and Part B: 1-800-772-1213
DSHS, Apple Health applications: 1-877-501-2233
Washington 211, community resources: dial 211
A licensed insurance agent with Benefits Life, for Medicare plan questions: (206) SENIORS (206-736-4677), TTY 711

More contacts are on our Washington Medicare phone numbers page.

Sources

Frequently asked questions

Can I make Medicare decisions for my parent?

Not without written authority. To let Medicare talk with you, your parent can fill out a Medicare authorization form or call 1-800-MEDICARE. For appeals and Social Security matters, they can appoint you as their representative. A durable power of attorney or health care power of attorney gives broader authority; set these up before a crisis.

Who can help me as a caregiver in Washington?

Community Living Connections (1-855-567-0252) connects caregivers to local long-term care services, the Family Caregiver Support Program and respite. For Medicare coverage questions, call 1-800-MEDICARE. A licensed insurance agent can help you and your family member compare plans from the companies they work with.

Does Medicare cover long-term care for my parent?

Generally no. Medicare covers skilled nursing facility care for up to 100 days per benefit period after a qualifying hospital stay, but not ongoing custodial care like help with bathing or dressing. Washington options include the WA Cares Fund (benefits since July 1, 2026, for people who qualify), Apple Health long-term care for those who meet its rules, and private long-term care insurance.

How can I help from another state?

Get your parent's written authorization first, so Medicare and their plan can talk with you. Ask the plan how to be listed as an authorized contact, arrange for plan letters such as the Annual Notice of Change to reach you, and plan a review together before Open Enrollment, which runs October 15 to December 7.

What signs of cognitive decline affect Medicare decisions?

Watch for unopened mail from Medicare or plans, confusion between Medicare and Medicaid, bills they don't remember, strangers calling about their Medicare number, and trouble refilling prescriptions. Untreated decline can lead to missed deadlines, coverage that doesn't fit, and fraud.

Medicare in your Washington county

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Licensed insurance agents for Washington

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