Does Medicare Cover Alzheimer’s Care?

Key Takeaways

• Original Medicare (Parts A & B) covers many diagnostic and treatment services for Alzheimer’s and dementia symptoms, but not long-term custodial care.
• Medicare Advantage plans can provide added support, like care coordination and transportation.
• Prescription drugs fall under Part D, which may cover both symptom-managing and newer treatments.
• Plan ahead: review costs, coverage gaps and out-of-pocket limits before choosing.

Alzheimer’s disease is the most common form of dementia. Alzheimer’s involves changes in the brain that lead to memory loss, difficulty with problem-solving and trouble with everyday tasks.

Common symptoms include:

• Forgetting names, dates or recent events
• Challenges with language and communication
• Visual-spatial difficulties
• Emotional changes like anxiety or irritability

There is no cure for Alzheimer’s, but early diagnosis and consistent care can help manage symptoms and improve quality of life. Knowing what Medicare covers can make all the difference for individuals and caregivers.

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Medicare Coverage for Alzheimer’s Disease

Original Medicare helps cover many of the services involved in diagnosing, treating and managing Alzheimer's disease. However, there are limitations, especially around long-term custodial care, which includes non-medical help with daily tasks like bathing, dressing or eating.

Here’s how each part of Medicare applies.

Diagnosis and Evaluation

Recognizing the signs of Alzheimer's early can make a difference in planning care, accessing resources, and starting treatment. Medicare Part B covers the diagnostic process used to assess memory loss or cognitive decline.

Covered services include:

• Doctor visits for cognitive assessments — Primary care providers or specialists can use screening tools to assess memory, thinking and orientation.
• Physical exams to rule out other causes — Certain conditions like thyroid disorders or vitamin deficiencies can mimic Alzheimer’s symptoms.
• Diagnostic imaging like MRI or CT scans — These scans help rule out strokes, tumors or structural brain issues.
• PET scans, which may be covered in some cases for early detection — A PET scan can detect abnormal amyloid deposits in the brain. Medicare may cover one PET scan per lifetime.

These services must be prescribed by your doctor and considered medically necessary as part of a formal care evaluation.

Treatment and Management

While Alzheimer’s disease cannot be cured, early and consistent treatment can slow progression and improve the person’s ability to maintain independence. Medicare helps cover a range of care services that support treatment and symptom management.

Covered services may include:

• Ongoing doctor visits and neurologist consultations—Continued care from memory specialists helps monitor symptoms, adjust medications.
• Home health care when medically necessary and prescribed — This includes skilled nursing, physical therapy or occupational therapy delivered in the home.
• Hospice care (covered by Medicare Part A, if the condition becomes terminal) if a physician certifies a life expectancy of six months or less, hospice services may include palliative care, pain relief and caregiver respite support.
• Medications (many of which are covered under Medicare Part D) — These drugs help manage symptoms like memory loss, confusion or behavioral changes. Part D must be added to Original Medicare.

Mental Health Services

Alzheimer’s can also cause mood changes like depression or anxiety. Medicare Part B covers mental health support.

Covered care may include:

• Therapy with psychiatrists, psychologists or social workers
• Yearly depression screening during a wellness visit
• Behavioral therapy for confusion or agitation

Medical Social Services

As needs grow, social workers can help patients and caregivers with emotional and practical support.

If part of a home health plan, Medicare may cover:

• In-home visits from licensed social workers
• Counseling and crisis support
• Help with care planning, financial aid or community resources.

Services must be doctor-ordered and coordinated with home care providers.

Medical Supplies

Medicare Part B covers some medical equipment that helps with safety and mobility.

Covered items may include:

• Walkers and wheelchairs
• Hospital beds
• Oxygen equipment (if needed for other conditions)

Equipment must be prescribed and ordered through a Medicare-approved supplier.

Prescription Drugs

Medicare Part D helps pay for Alzheimer’s medications and must be added separately unless included in a Medicare Advantage plan.

Here’s what may be covered:

• Drugs for memory or confusion
• Antidepressants for mood
• Antipsychotics for agitation or behavior
• Anti-amyloid drugs like Leqembi or Kisunla, if eligible and enrolled in a CMS registry.

Check your plan’s drug list, or formulary, for specific coverage.

What Original Medicare Does Not Cover

While Medicare covers many necessary medical services, it does not pay for most custodial or long-term care needs related to Alzheimer’s disease.

Long-term Care

Medicare does not cover the cost of:

• Nursing home care beyond 100 days
• Assisted living facilities
• Adult daycare centers, which offer supervision and structured activities

Personal Care (Custodial Care)

Medicare does not help with daily living activities unless they’re part of a short-term home health plan.

This includes:

• Bathing, dressing, and meal preparation
• Personal aid assistance, unless provided through a Medicare-covered home health benefit under Part A

Other Exclusions

Medicare also does not pay for:

• Over-the-counter vitamins and supplements
• Incontinence supplies
• Temporary breaks for caregivers (known as respite care), unless provided through a hospice plan under Medicare Part A

Planning ahead for these expenses is important, as they often represent the most significant costs for Alzheimer’s caregivers and families.

Additional Medicare Coverage Options

If you’re exploring coverage beyond Original Medicare, Medicare Advantage (Part C) can offer more help for Alzheimer’s and dementia care.

Medicare Advantage (Part C)

Medicare Advantage is not an add-on because it replaces your Original Medicare (Parts A and B). These plans are offered by private insurers and must cover the same services as Original Medicare and often include extra support.

Some plans offer:

• Care coordination services
• Transportation to appointments
• Expanded home care benefits

In some areas, there are Special Needs Plans (SNPs) tailored to people with dementia, offering enhanced support and caregiver services.

Medicare Part D

Prescription drug plans (PDPs) help cover medications not administered by a healthcare professional. Many stand-alone Part D plans are available, or drug coverage may be bundled into a Medicare Advantage plan (MAPD).

Be sure to check that medications are included in the plan’s list of covered drugs (formulary).

8 a.m.-8 p.m., 7 days a week.

FAQs

Does Medicare cover in-home care for Alzheimer’s patients?

Yes, Medicare Parts A and B may cover in-home care if it’s medically necessary and ordered by a doctor. This can include skilled nursing care, physical therapy and home health aide support on a short-term basis.

Does Medicare cover memory care?

Medicare does not cover the cost of memory care facilities. However, it may cover medical services provided at those facilities.

Does Medicare pay for assisted living for Alzheimer’s?

No, Medicare generally does not cover assisted living, as it is considered custodial care. This includes help with daily activities like bathing, dressing and eating.

Does Medicare cover home health care for dementia?

Yes, Medicare covers home health care for people with dementia if it’s medically necessary, intermittent and ordered by a Medicare-approved provider. Covered services may include nursing care, occupational therapy or speech-language pathology.

Does Medicare cover nursing home care for dementia?

Medicare will cover short-term nursing home care after a qualifying hospital stay, but not for long-term dementia care. Coverage typically ends after 100 days.

Does Medicare cover early-onset Alzheimer’s care?

Yes. People under 65 with early-onset Alzheimer's may qualify for Medicare after receiving Social Security Disability benefits for 24 months. Coverage is similar for individuals 65 and older.

What does Medicare Advantage cover that Original Medicare does not?

Medicare Advantage plans often offer more comprehensive and supportive services for Alzheimer’s care beyond what Original Medicare includes. These may include care coordination, transportation, in-home support services or more.

Note: Benefits vary by plan and location. Always check the details of your specific plan to understand exactly what’s covered.

Sources

• NIH: What is Alzheimer's Disease?
• alz.org: What is Alzheimer's Disease?
• Medicare.gov: Home health services
• Medicare.gov: Hospice care
• Alz.org: Medicare
• Uhc.com: Does Medicare cover Alzheimer's care?
• aarp.org: Does Medicare cover dementia care?

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Disclaimers