Medicare and Alzheimer’s/Dementia: What Help Is Available?

A diagnosis of Alzheimer’s disease or dementia can be overwhelming — for both the person affected and their loved ones. Many families ask: “What does Medicare cover for Alzheimer’s or memory care?” “Can we get help with caregiving, home care, or medications?” Here’s a clear breakdown of what Medicare does cover, what it doesn’t, and what additional support may be available.

 What Medicare Covers for Alzheimer’s and Dementia

Medicare doesn’t have a special program just for Alzheimer’s, but it does cover medically necessary services related to the diagnosis and ongoing care, including:

 Covered Services:

Diagnosis & cognitive assessments	Part B – annual wellness visit includes memory screening
Doctor visits & specialist care	Part B – neurologists, psychiatrists, primary care
Lab tests & brain scans (MRI, CT)	Part B
Prescription drugs	Part D or MAPD plan – e.g., donepezil (Aricept), memantine
Home health care (short-term)	Part A & B – if ordered by a doctor and patient is homebound
Skilled nursing care (short-term)	Part A – after a hospital stay, up to 100 days
Hospice care	Part A – for end-stage dementia

 These services are only covered if considered medically necessary and provided by Medicare-approved providers.

 What Medicare Doesn’t Cover

• Long-term custodial care (help with eating, bathing, dressing)
• Assisted living or memory care facility costs
• Adult day care
• Respite care (except short-term under hospice)

 These services may be available through:

• Medi-Cal (Medicaid in California)
• Long-term care insurance
• Veteran’s benefits
• State or nonprofit caregiver programs

 Medicare Advantage (MAPD) and Special Needs Plans (C-SNPs)

Some Medicare Advantage plans and Chronic Special Needs Plans (C-SNPs) offer extra support for people with Alzheimer’s or dementia.  May include:

• Care coordination
• Case management
• Transportation to appointments
• OTC cards
• Access to support groups and telehealth

 Availability depends on your ZIP code — we can help check if you qualify.

 Support for Caregivers

While Medicare doesn’t directly pay family caregivers, it does help in these ways:

• Covers training and education during home health visits
• Pays for hospice respite care (up to 5 days at a time)
• May allow telehealth check-ins with care teams

 Additional help is often available through:

• Alzheimer’s Association
• Area Agency on Aging (AAA)
• California Department of Aging
• Medi-Cal in-home support services (IHSS)

 FAQs: Medicare & Alzheimer’s Coverage

1. Does Medicare pay for memory care facilities?

 No. Medicare does not pay for room and board in memory care or assisted living.

2. Will Medicare pay for 24-hour home care?

 No — Medicare only covers intermittent skilled nursing or therapy, not full-time personal care.

3. Can I get help paying for drugs like Aricept?

 Yes — through Part D or a MAPD plan. We can help find low-cost options.

4. Does Medicare cover adult day care?

 No — but Medi-Cal or local programs may provide funding.

 Let Us Help You Navigate Medicare and Memory Care

At Peace & Grace Insurance Services, we:

• Help families understand what Medicare covers for dementia
• Review plan options with extra benefits for memory care
• Assist with Medi-Cal applications for long-term support
• Connect you with local caregiver resources

 Call/Text: 209-812-4026  Email: CSinsurepng@icloud.com  Proudly serving all counties in California