Medicare typically does cover some costs related to dementia care. The part of Original Medicare (Part A and Part B) that covers your dementia care will depend on the type of facility in which you receive care.
Medicare Advantage (Part C) plans can also cover dementia care.
Some Medicare Advantage plans may also offer additional benefits that can help with dementia care, such as home modifications, adult day care and non-medical care at home, all of which are not typically covered by Original Medicare.
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Speak with a licensed insurance agent
Plan benefits may vary and may not be available in all locations.
Call to speak with a licensed insurance agent who can help you determine your eligibility to enroll and find Medicare Advantage plans in your area that offer dementia care benefits at TTY Users: 711, 24/7.
Original Medicare may cover some but not all costs related to dementia care.
Medicare Part A hospital insurance will typically cover some of the following costs:
Medicare Part B may cover other services related to dementia care, such as:
Speak with your doctor directly for more Medicare coverage information related to your dementia or Alzheimer’s care.
As part of the Chronic Care Act of 2018, Medicare Advantage plan providers are able to provide expanded benefits to their beneficiaries, called “supplemental benefits,” starting in 2019 and 2020.
Some of these additional benefits may include:
Because Medicare Advantage plans are sold by private insurance companies, plan availability and the benefits they offer may vary from one location to another.
To learn more about Medicare Advantage plans in your area, your eligibility to enroll, and the benefits that they offer, call to speak with a licensed insurance agent today.
Compare Medicare Advantage plans in your area
Compare PlansOr call TTY Users: 711 24/7 to speak with a licensed insurance agent.
Depending on the type of dementia care you receive, you may be responsible for different types of Medicare costs, such as:
You must meet the Part A deductible before your Part A coverage kicks in for inpatient care related to dementia.
The Medicare Part A deductible is $1,556 per benefit period in 2022.
The Part A deductible is not annual, and you could experience more than one benefit period in a calendar year. A benefit period starts the day you are admitted for inpatient care and ends when you have not received inpatient care for 60 consecutive days.
If Part A covers hospice care related to your dementia or Alzheimer’s disease, you pay nothing for your hospice care, including the Part A deductible.
You may need to pay a 5 percent coinsurance for the Medicare-approved amount for inpatient respite care, as well as a $5 copayment for your prescription drugs while receiving hospice care.
If you experience an inpatient hospital stay related to your dementia care, you will typically be responsible for the following coinsurance costs after meeting your deductible:
You cannot accrue any additional lifetime reserve days.
If you are admitted to a skilled nursing facility for care, you will be responsible for the following coinsurance costs:
You must meet your Part B deductible before your Part B coverage for things like occupational therapy and doctor’s office visits kicks in.
The Medicare Part B deductible is $233 per year in 2022.
After you meet the Part B deductible, you typically pay 20 percent of the Medicare-approved amount for most doctor’s services.
There is no annual limit on how much you could pay for the Part B coinsurance in a given year.
Special Needs Plans are a type of Medicare Advantage plan that can offer specialized care and coverage specifically limited to patients with a certain condition or situation, such as dementia or Alzheimer’s disease.
Medicare SNPs are not available in all locations. If an SNP is available near you, you may be able to enroll and enjoy benefits such as:
Learn more about the Medicare SNPs that may be available in your area and if you meet the eligibility criteria. If none are available, you may be able to find another type of Medicare Advantage plan that fits your coverage needs.
Compare Medicare Advantage plans in your area
Compare PlansOr call TTY Users: 711 24/7 to speak with a licensed insurance agent.
Compare your Medigap plan options by visiting MedicareSupplement.com
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