Does Medicare Cover Alzheimer's?

Does Medicare Cover Memory Care

Medicare does cover Alzheimer's disease treatment and dementia care that's deemed medically necessary by a physician. This can include both inpatient and outpatient care.

You'll typically be required to pay some out-of-pocket Medicare costs for your covered Alzheimer's disease treatment.

A Medicare Supplement (Medigap) plan can help cover Alzheimer's disease treatment costs, such as Medicare deductibles, coinsurance, copays and more.

Medigap plans can help cover your Alzheimer's treatment Medicare costs.

How Does Medicare Pay for Alzheimer's Care?

Medicare can help seniors diagnosed with Alzheimer's and other cognitive disorders pay for some of the costs related to their care.

Medicare will cover services that are deemed medically necessary by a doctor. With Alzheimer's patients, this can include both inpatient (Medicare Part A) and outpatient (Medicare Part B) care.

• Medical services (doctor's visits, lab tests and medical supplies) fall under the Medicare Part B coverage umbrella.
  
  You must meet your Part B deductible ($240 per year in 2024) before your coverage kicks in. You then typically pay 20% of the cost of services you receive (Part B pays the other 80%).

• Medicare Part A will help pay for hospital care and other inpatient services, like skilled nursing facility care. However, your Part A benefits cap skilled nursing care at 100 days at a time.

• Medicare typically does not cover custodial care (non-medical assistance with routine daily activities, like bathing, eating and getting dressed) at home or in a nursing home if that's the only care you need.

• Part A also covers hospice services, if needed.

A private Medicare Part D Prescription Drug Plan may help pay for some of the medications required for Alzheimer's treatment, if they are included in your plan's formulary (the list of covered drugs).

Alzheimer’s affects more than 5 million Americans over the age of 65.¹ 

Medigap Plans Can Help Pay for Alzheimer's Treatment

Even with Medicare Part A and Part B, you may be responsible for several out-of-pocket Medicare costs.

Medicare Supplement Insurance helps cover some of these expenses.

For example, each of the 10 standardized Medigap plans that are available in most states provide at least partial coverage for the Medicare Part B coinsurance or copayments you might face when you receive covered outpatient Alzheimer's disease treatments.

A licensed agent can help you decide on a Medicare option that works for you. Call today to speak with a licensed agent and compare the Medigap plans that are available where you live.

Does Medicare Cover Nursing Home for Alzheimer's?

Medicare provides coverage for certain expenses incurred in a memory care facility. While it does not cover all long-term care costs, it does offer coverage for the following services:

• Inpatient hospital care
• Semi-private rooms
• Meals
• General nursing care
• Medications
• Hospital supplies
• Diagnostic testing
• Up to 100 days of skilled nursing home care
• Hospice care

¹ Matthews, K. A., et al. (2018). Racial and ethnic estimates of Alzheimer’s disease and related dementias in the United States (2015–2060) in adults aged≥ 65 years. Alzheimer’s & Dementia. doi.org/10.1016/j.jalz.2018.06.3063.

Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.