Does Medicare cover Alzheimer’s care?

Does Medicare cover Alzheimer's care? Original Medicare and Medicare Advantage will generally cover diagnostic tests, short-term treatment plans, and prescriptions if they are considered medically necessary. However, Medicare lacks in its long-term care options. Learn more below about Medicare Alzheimer's care coverage options.

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D. Gilson is a writer and author of essays, poetry, and scholarship that explore the relationship between popular culture, literature, sexuality, and memoir. His latest book is Jesus Freak, with Will Stockton, part of Bloomsbury’s 33 1/3 Series. His other books include I Will Say This Exactly One Time and Crush. His first chapbook, Catch & Release, won the 2012 Robin Becker Prize from Seve...

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Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...

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Reviewed by Leslie Kasperowicz
Farmers CSR for 4 Years

UPDATED: Dec 8, 2020

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The Highlights

  • Original Medicare and Medicare Advantage will generally cover short-term diagnostic tests and treatments for Alzheimer’s.
  • Medicare will generally cover Alzheimer’s care that is considered medically necessary.
  • Medicare is lacking in coverage for long-term care coverage, so you may need to seek assistance from another health insurance policy or community resource.

Alzheimer’s disease can be scary for both the patient and their caregivers, especially when the costs of medical care begin to add up beyond management. Medicare health insurance plans are commonly used amongst individuals most likely to be afflicted by Alzheimer’s.

But does Medicare cover Alzheimer’s care? What diagnostic, short-term care, and long-term services will be covered in the case that you or a family member is diagnosed with Alzheimer’s? Let’s find out about Medicare and what coverage it offers to Alzheimer’s patients.

We’ll answer these questions below. Before you begin reading, if you need help finding health insurance quotes, enter your ZIP code above to use our free comparison tool.

Does Medicare Cover Alzheimer’s Care?

Medicare will generally cover Alzheimer’s care that is considered medically necessary. Original Medicare will usually cover inpatient and outpatient treatment for Alzheimer’s, while Medicare Part D will cover many of the necessary prescriptions.

Your out-of-pocket expenses will consist of premiums, deductible, and copayments or coinsurance. If you have a Medigap plan, this can help cover some of theses expenses.

Original Medicare, as well as Medicare Advantage, covers one Medicare annual wellness visit and health risk assessment per year. During these visits, it is advised to talk to your doctor if you feel that you are experiencing symptoms or may be at risk of Alzheimer’s disease. These assessments can help early diagnosis.

After diagnosis, patients and caregivers can take advantage of Medicare’s care planning, where they can learn about treatments, community resources, and care tips. Medicare may also cover therapy sessions to help with symptoms such as depression.

In some situations, Medicare will cover up to 100 days of skilled nursing home care after a hospitalization. In the long-run, however, patients and their families will need to seek insurance or financial assistance from somewhere else to get help paying for long-term care.

For patients seeking end-of-life care, Medicare may cover hospice care that can be performed in home or at a facility.

Medicare Advantage may cover more than what original Medicare does, so you should contact your policyholder to understand what your insurance company will offer. You may also seek a Special Needs Plan (SNP) for Alzheimer’s disease — a Medicare Advantage plan specifically for those with Alzheimer’s.

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Conclusion

Original Medicare and Medicare Advantage will usually cover early-stage Alzheimer’s, middle-stage Alzheimer’s, and late-stage Alzheimer’s care, as well as cognitive assessment and care plan services, to the extent that is medically necessary. However, Medicare tends to be lacking when it comes to long-term care, so it would be wise to seek out supplementary health insurance, a Special Needs Plan for Alzheimer’s, or other financial assistance for long-term needs.

Medicare Part D will cover prescriptions that are on the approved drug list, and Medigap may be able to help cover out-of-pocket expenses.

If you need help finding affordable health insurance for Alzheimer’s care, enter your ZIP code below to start comparing quotes now.

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