Alzheimer’s care is two jobs, and Medicare pays for only one
In short: Alzheimer’s care is medical care plus daily care. Medicare pays for much of the medical side, such as diagnosis, a care planning visit, skilled home health and hospice. It generally does not pay for the daily side: bathing, supervision and memory care housing.
Most families find this out late. The doctor says "Alzheimer's", someone mentions "care", and you assume one insurance card covers one thing called care. It covers two things. The split is where the surprise bills and the exhausted evenings come from, and nobody explains it at the appointment.
If your parent has just been diagnosed, a navigator can book the follow-ups and track them while you sort out the rest. Navigate Care explains how that works on its dementia page. A navigator does not treat dementia or give medical advice. The doctor does that.
What Medicare covers for Alzheimer’s care
The most useful benefit is one many families never hear about. CMS says Medicare covers a separate visit for a detailed cognitive assessment and care plan when a provider sees signs of impairment. It is longer than a normal appointment. It includes a check of daily activities, medication review, a home and driving safety look, and advance care planning.
CMS notes that an independent historian must be present to give history. That is you. Go, and bring notes.
The visit ends with a written plan. It covers behaviour and memory symptoms, what your parent can no longer do alone, and referrals to community help such as adult day programs and support groups. Ask for it by name: "a cognitive assessment and care plan visit." Ordinary Part B costs may apply, so ask the office what your parent will owe first. Our Medicare Part B guide explains how those costs work.
Alzheimer's care, sorted by who usually pays
| What your parent needs | Medicare? |
|---|---|
| Diagnosis, doctor visits, cognitive assessment | Usually yes, under Part B |
| Skilled nursing or therapy at home | Yes, if homebound and ordered by a doctor |
| Hospice in the late stage | Yes, if the doctor certifies 6 months or less |
| Bathing, dressing or supervision as the only need | No |
| Memory care room and board | No |
Source: CMS; coverage limits as set out in our guides on home health and hospice
What Medicare does not cover
The Alzheimer's Association describes three stages, and the middle one is typically the longest. Your parent can still do daily activities with help. That help is the expensive part. It's custodial care, and Medicare generally doesn't pay for it, whether it comes from an aide at home or a memory care community.
You are not failing at this when the bills start. The programme draws the line there. Our guide on getting a caregiver through Medicare shows what an aide visit can and can't be.
Some Medicare Advantage plans offer in-home help with daily tasks. Others don't. Read your parent's plan documents, and ask the plan in writing.
Where help with daily care comes from
Start local. The Eldercare Locator finds your Area Agency on Aging: call 1-800-677-1116. Ask about the family caregiver support programme, respite care and adult day centres. The Alzheimer's Association's 24/7 Helpline is 800.272.3900, for crisis help and local resources.
For paying for long-term care, Medicaid may help if your parent meets your state's income and asset limits. The look-back rules matter, so read Medicaid vs Medicare and ask SHIP, which is free, or your state Medicaid agency before moving money. We don't give legal or financial advice.
Late in the illness, the Alzheimer's Association says hospice can support the person and the family. Our post on hospice coverage covers what it pays.
First steps this month
- Book the cognitive assessment and care plan visit, and go with your parent.
- Get your parent's permission on file so the doctor and Medicare can talk to you. Do it while your parent can sign.
- Call the Eldercare Locator and ask what your area offers.
- Find out whether your parent has Original Medicare or Medicare Advantage.
- Ask SHIP or your state Medicaid agency about long-term care costs before you need them.
For more on who counts as a caregiver and where support sits, see What Is a Caregiver?
Frequently asked questions
Does Medicare cover Alzheimer's care at home?
Only the skilled part. Medicare may send a nurse or therapist if your parent is homebound and a doctor orders it. It generally doesn't pay for round-the-clock or personal care on its own.
Does Medicare pay for memory care?
Generally no. Memory care housing is mostly custodial care, which Medicare doesn't cover. Medicaid may help people who meet their state's limits.
Who can talk to the doctor for my parent with Alzheimer's?
Usually you need your parent's permission on file, or legal papers if they can no longer sign. Ask the doctor's office and 1-800-MEDICARE what they accept.
What is a cognitive assessment and care plan visit?
A separate Medicare-covered visit, according to CMS, for a detailed look at memory and daily function, ending in a written care plan with referrals to community resources.
Can I get paid to care for my parent with Alzheimer's?
Medicare doesn't pay family members for caregiving. Ask your Area Agency on Aging what exists in your state.
