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The aging process can bring about considerable changes in memory and cognitive function. For some, these changes are mild and manageable, while for others, they progress into more severe conditions like Alzheimer’s disease or other forms of dementia.
The term ‘memory care’ might sound like a set of practices to help you take care of your own memory. In the medical community, however, it refers to the typically long-term specialized care and services provided to individuals with significant memory loss or cognitive decline.
As you age, maintaining cognitive health becomes increasingly important, and knowing what options are available for memory care is crucial. All the more so considering that an estimated 6.7 million Americans above the age of 65 are afflicted with Alzheimer’s disease.
Memory care facilities are a specialized care and support haven for such individuals and their families. That brings us to the question, ‘Does Medicare cover memory care?’
Understanding Memory Care
Memory care is a specialized form of assisted living designed to cater to the unique needs of individuals living with Alzheimer’s disease, dementia, and other similar conditions.
Memory care facilities provide a safe and structured environment where residents receive assistance with activities of daily living (ADLs), medication management, cognitive therapies, and activities to slow cognitive decline.
Their services include those commonly offered by assisted living facilities, such as private or shared apartments, meals and snacks, housekeeping and laundry, and personal care services.
They also have several additional features:
- Secure Environments: Memory care facilities are designed with security features like locked doors, enclosed outdoor spaces, and alarm systems to prevent patients from wandering off.
- Specialized Staff: Staff members trained specifically in dementia take care to understand and address the unique challenges of memory-impaired residents.
- Personalized Attention: Care facilities are equipped to provide dementia-specific care and activities, like gardening, exercise, and cognitive games and therapies.
Does Medicare cover Memory Care?
Medicare is a federally-mandated health insurance scheme open to all Americans aged 65 or older, besides younger individuals with certain covered diseases and disabilities. It includes multiple plan options and add-on services that can be tailored to your particular healthcare needs.
Unfortunately, Medicare doesn’t typically cover the cost of room and board in memory care facilities. That is because memory care is considered custodial care rather than skilled nursing care.
There are still some services, however, that Medicare may cover under specific conditions:
- Cognitive Assessments: Medicare Part B (Health Insurance) covers cognitive assessments to diagnose dementia or Alzheimer’s.
- Skilled Nursing Care: Medicare Part A (Hospital Insurance) covers up to 100 days of skilled nursing care in a facility following a hospital stay.
- Care Planning: Medicare Part B covers care planning services for newly diagnosed dementia patients, helping them understand their treatment options and available resources.
- Prescription Drugs: Medicare Part D covers certain prescription drugs used to manage symptoms of dementia and Alzheimer’s.
Let’s now address the question, ‘Does Medicare cover home health care for dementia?’
For the homebound, Medicare covers limited home health care services, such as skilled nursing and therapy, but not personal care or housekeeping.
For clarity, these are the services not covered by Medicare:
- Long-Term Memory Care: Medicare does not cover the cost of long-term memory care or assisted living services, including room and board in a memory care facility.
- Custodial Care: Assistance with activities of daily living, such as bathing, dressing, and eating, is not covered unless it is part of a short-term skilled nursing care plan following a hospital stay.
- Alternative Therapies: Medicare does not cover treatments like acupuncture or herbal medicine.
It’s worth noting that there are additional coverage options for beneficiaries requiring memory care, many of which depend upon private insurers:
- Medicare Advantage Plans (Part C): Private insurance companies offer these plans that often provide additional benefits, including coverage for certain long-term care services. Check with your plan provider to understand your options.
- Medigap: Supplemental insurance that helps cover out-of-pocket costs not covered by original Medicare, such as copayments and deductibles.
Where Can I Find a Memory Care Facility Near Me?
Finding the right memory care facility can be challenging.
Resources like Medicare’s Nursing Home Compare tool can be invaluable for those searching for ‘memory care facilities near me that accept Medicare’. This tool allows you to search for facilities based on location and provides detailed information about the services and quality of care.
Other tools include US News and World Report’s searchable list of best memory care communities and advice from your local Alzheimer’s Association chapter.
CoverRight helps you understand your Medicare options, compare plans, and find solutions that fit your needs and budget. We’re your personal concierge for all things Medicare!
Get started with us for free!
Frequently Asked Questions (FAQ)
Q: Are memory care facilities the same as assisted living?
While both offer assistance with daily activities, memory care facilities provide specialized care for individuals with memory loss, including secure environments, cognitive therapies, and staff trained in dementia care.
Q: Does Medicare cover home health care for dementia patients?
If certain conditions are met, Medicare might cover some in-home care services, like skilled nursing or physical therapy. It does not, however, cover long-term custodial care at home.
Q: How much does memory care cost?
The cost of memory care can vary widely depending on location, the level of care needed, and the amenities offered by the facility. Dementia Care Central reports that the average monthly cost of memory care in an assisted living facility is $6,160, or about $73,920 annually.
This is merely an indicative figure, however, and actual costs can be much higher.
Q: What are other options for paying for memory care?
Besides Medicare, other options for financing memory care include long-term care insurance, Medicaid (for those who meet income and asset limits), veterans’ benefits, and personal savings.
