Will Medicare pay for assisted living for dementia patients?

While living with dementia can be incredibly difficult, taking care of a loved one with dementia is also stressful and emotionally draining. When a loved one’s case of dementia has progressed to the point of them needing 24-hour care, the best option for them and their family is to get the loved one into an assisted-living program.

Many seniors depend on Medicare for their health insurance. When thinking about diseases such as dementia, the question quickly becomes, “Does Medicare pay for home healthcare for patients with dementia?” or “Does Medicare pay for assisted living?”

Assisted-living care for a patient with dementia or in-home dementia care costs can quickly get expensive. You should find health insurance that pays for extended care before you or a loved one needs it.

Does Medicare cover assisted living for dementia patients? Medicare Advantage plans can help you get the care you need. Enter your ZIP code into our free tool to see what rates might look like for you.

Memory Care Facilities That Accept Medicare

According to the Alzheimer’s Association, an estimated 6.2 million Americans age 65 and older are living with Alzheimer’s dementia in 2021.

Medicare does not cover long-term healthcare, such as that provided by an assisted-living program. Medicare will cover the following services:

• Inpatient hospital care
• General nursing care
• Semi-private rooms
• Meals
• Medications (if you have Medicare Part D)
• Hospice care
• 100 days of skilled nursing home care
• Diagnostic testing
• Hospital or healthcare supplies

Read more: Will health insurance pay for hospice?

If a patient with dementia needs long-term assisted-living care, they will have to find another way to pay for it.

How can you pay for memory-care facilities?

If you find yourself in need of quality healthcare assistance for a dementia patient before you decide that you are going to be paying out-of-pocket costs for care, explore your financial resources and consider the following options.

• Private savings. Of course, you can always pay for healthcare with cash from a personal savings account, or the sale of a house or any other liquid assets a senior might no longer need.
• Private insurance. While Medicare is a senior’s primary insurance, they might have other or supplemental insurance plans. A plan from a private insurance company or other insurance may help pay for the costs of Alzheimer’s care.
• Individual Retirement Accounts. If the dementia patient has an IRA or annuities, these can be applied to either Alzheimer’s home care or an assisted-living facility.
• Private organizations. People are usually willing to help others out, and helping people with dementia is no different. The costs of Alzheimer’s care may be handled by church groups, volunteers, and even some state programs.

Even though Medicare doesn’t cover assisted-living programs, you can still get the help you need to pay for care if you know where to look.

Can Medicare Advantage help pay for long-term care?

Traditionally, the answer is no, Medicare Advantage does not cover long-term stays in a facility for dementia or any other health problem.

However, the Medicare program is beginning to let Medicare Advantage — or Medicare Part C — insurers cover long-term care.

Currently, Medicare Advantage is focused on providing long-term care to patients with serious illnesses or conditions and less on daily-living help.

The best way to see if you or a loved one qualifies for long-term care with a Medicare Advantage policy is to compare quotes and contact an agent.

Find Dementia Care Through Medicare Advantage Plans

Dealing with dementia is stressful enough. You shouldn’t have to worry about paying for your loved one’s dementia care. While original Medicare can’t help out very much, a Medicare Advantage plan might be able to cover some of your loved one’s needs when it comes to individuals with dementia.

If you’re ready to learn more about how Medicare Advantage can help with assisted living for dementia, you should shop around for quotes. If you’re ready to see what quotes might look like for you, enter your ZIP code into our free tool.

1. https://www.cdc.gov/aging/publications/features/Alz-Greater-Risk.html#:~:text=Current%20estimates%20are%20that%20about,65%20with%20younger%2Donset%20Alzheimer’s.