Has your senior been diagnosed with Alzheimer’s or dementia? Have you been able to answer the question: “Does Medicaid and Medicare pay for memory care?” If not, this blog will help you navigate the tricky terrain that is financial coverage for memory care services.
A memory care facility differs from that of a senior living facility or a retirement home in that it provides specific care for an individual with memory care needs. Assisted living facilities were created for older adults who can maintain most of their independence. Memory care facilities provide memory care services such as medication management, nutrition monitoring, memory-enhancing activities, and incontinence care, to name a few.
Memory care facilities form a structured, safe environment with routines to lower stress for people with Alzheimer’s or dementia. Unfortunately, these specialized services are costly. Here we discuss the coverage Medicare and Medicaid provide for memory care and what to do about out-of-pocket costs.
Cover Provided by Medicaid
Memory care falls under Medicaid’s nursing facility services and is therefore covered. The services delivered, however, differ by state. In Arizona specifically, Medicaid can cover around 50% of memory care costs. For more information on how much cover you qualify for, please visit Memory Care.com. They give extensive details on how much Medicaid contributes to memory care.
Certain benefits are federally mandatory. States then have the option to provide extra help to individuals with dementia. Examples of services offered by Medicaid with regards to memory care are the following:
- Nursing facilities
- Transportation to medical care
- Home health services
- Early and periodic screening, diagnostic, and treatment services
- Inpatient hospital services
- Outpatient hospital services
- Prescription medication
- Federally qualified health center services
- Laboratory and X-ray services
Cover Provided by Medicare
Medicare covers some memory care services, but not all as it is considered long-term care, which is not covered. As a result, the shortfall can lead to high out-of-pocket costs.
Here are the limited memory care services covered by Medicare:
- Home health care
- Hospice care services (pain relief in end-stage dementia)
- Inpatient care for clinical research studies
- Up to 100 days of skilled nursing care
- Cognitive impairment assessment
- Annual wellness visits
- Durable medical equipment
Original Medicare is not your only option – they also contract with private insurance companies. These additional Medicare-approved policies may reduce your expenses:
Medicare Special Needs Plans (SNPs)
Medicare Supplement Insurance (Medigap)
Paying for Memory Care
As we have seen, only a portion of memory care is covered by Medicare and Medicaid. You or an aging loved one may need to access additional ways to supplement memory care costs. Other resources that may assist, as per The Alzheimer’s Association, are the following:
- Retirement funds
- Personal savings and assets
- Tax deduction and credits
- Social Security Disability insurance
- Supplement Security Income
Conclusion
If you or a loved one need memory care, start planning as soon as a diagnosis is received. Early planning will enable you to find the right memory care facility and help you understand what costs will be covered by Medicaid or Medicare, and know what your other financing options are.
Realize that although this is a daunting diagnosis, you are not alone. In fact, according to Alzheimer’s Disease Facts and Figures, there are more than 6 million American’s living with Alzheimer’s disease. In addition, memory care facilities are equipped with you or your senior’s specific needs in mind.
If you need any further assistance or would like access to further resources, please reach out. We will direct you to the right resources for memory care services, at no cost to you.
This post was inspired by an article published by Senior Living. To view the full version, click here.
