[PLACEHOLDER] Does Medicare Cover a Geriatric Care Manager?

The Short Answer (and Why It's Misleading)

If you Google "does Medicare cover a geriatric care manager," you'll get a consistent answer: no. And technically, that's correct. Medicare does not cover private geriatric care managers — the independent professionals who charge $150 to $350 per hour to help families navigate aging.

But here's what that answer misses: Medicare absolutely does cover care management. It just calls it something different.

Since 2015, Medicare has offered Chronic Care Management (CCM) and Principal Care Management (PCM) programs that pay for exactly the kind of coordination families are searching for when they look up geriatric care managers. The service exists. It's covered. Most families just don't know about it.

What a Geriatric Care Manager Actually Does

Before we get into the Medicare side, it helps to understand what families are really looking for when they search for a geriatric care manager. Usually, it's someone who can:

• Coordinate between multiple doctors and specialists

• Manage complex medication regimens

• Help navigate insurance and benefits

• Provide a single point of contact for health-related questions

• Offer guidance during health crises or hospitalizations

• Keep family members informed and aligned

These are real, important needs — especially when your parent has multiple chronic conditions and you're trying to manage everything from a distance or while juggling your own life.

The Private-Pay Problem

Traditional geriatric care managers (also called aging life care managers) provide excellent service. But the cost puts them out of reach for most families. At $200+ per hour, even a few hours a month adds up to thousands of dollars — none of it covered by insurance.

This creates a gap: the families who need the most help often can't afford it.

What Medicare Actually Covers

Medicare's CCM and PCM programs were designed to fill exactly this gap. Here's how they work:

Chronic Care Management (CCM)

If your parent has two or more chronic conditions expected to last at least 12 months, they qualify. A care manager provides at least 20 minutes of coordination per month — reviewing medications, talking to doctors, updating care plans, and being available when questions come up.

Principal Care Management (PCM)

If your parent has a single serious chronic condition that requires intensive management, PCM provides focused coordination for that condition.

What It Costs

Medicare covers the service. If your parent has a Medigap supplement plan or Medicaid, the copay is typically $0. About 90% of Hera's clients pay nothing out of pocket.

How Hera Bridges the Gap

Hera was built around a simple insight: families shouldn't have to pay hundreds of dollars an hour for care coordination that Medicare already covers.

Our care managers — we call them Heroes — are trained geriatric social workers who provide the same caliber of support you'd get from a private geriatric care manager. The difference is how it's paid for. Hera bills Medicare directly through CCM and PCM, so your family gets ongoing, professional care management without the private-pay price tag.

What Makes It Different

• It's ongoing, not one-time. Your parent gets a dedicated Hero who knows their full medical history, not a consultant who parachutes in for an hour.

• It's proactive. Heroes reach out regularly, catch issues early, and prevent the crises that send families scrambling.

• It's covered. No surprise bills. No retainers. Medicare pays for the service because it works — coordinated care reduces hospitalizations and improves outcomes.

The Bottom Line

Medicare doesn't cover the title "geriatric care manager." But it does cover the work. If your parent qualifies — and most seniors with chronic conditions do — there's no reason to pay out of pocket for care coordination that Medicare will fund.

Check your parent's eligibility with Hera. It takes five minutes, costs nothing, and could save your family thousands.