If you or a loved one is dealing with memory loss, or has been diagnosed with dementia or Alzheimer’s, you’re probably feeling scared, stressed, and defeated. Medical bills only add to this difficulty. Since memory loss most often affects seniors, and Medicare is for people who receive Social Security retirement benefits and are over 65, many people with memory loss already have Medicare. To lessen the financial stress of a memory loss issue or dementia diagnosis, it’s important to understand what is covered by Medicare. There are different levels of Medicare available, and each one covers different things. Medicare can cover certain portions of the services listed below, among others.

Assessing Memory Loss

Medicare Part B covers annual wellness visits, which are yearly visits for one’s doctor to assess their overall health. Since memory loss and dementia affect many seniors, if you are a senior, your doctor will most likely assess your cognitive function during these visits to see if you may have problems with memory. Your doctor will consider many things, such as any concerns or observations from loved ones, as well as your cognitive abilities. Sometimes, there can be further testing needed as well, like CT scans, MRIs, or bloodwork, and Medicare Part B will cover these as well.

Skilled Nursing Facilities

Skilled nursing facilities have healthcare professionals who can provide inpatient care. These facilities are different from nursing homes. Nursing homes provide custodial care, while skilled nursing facilities provide medical care and employ nurses supervised by doctors. Unlike nursing homes, they are not meant for long-term care but for short-term medical care. Many times, patients may stay at these facilities after they are able to leave the hospital but still need daily care.

Medicare Part A covers all the costs of skilled nursing facilities for 20 days. After that, you’ll be charged $176 daily for the next 80 days. Unfortunately, after a total of 100 days, Medicare will no longer cover staying at a skilled nursing facility.

Hospital Stays

Alzheimer’s or dementia patients may need to stay in the hospital for certain periods of time. If you or your loved one has Medicare Part A, it can cover any hospital stays in full for the first 60 days of the stay. After 60 days, but before 90 days, you’ll need to pay $352 daily, and Medicare will not cover anything after the 90-day period is up.

Hospice Care

Hospice care is not meant to save one’s life but to provide care and comfort to people at the end of their lives. Medicare Part A will cover hospice care if certain conditions are met. You or your loved one with dementia must have agreed not to expect to be cured and signed a document saying that you agree to be treated by hospice care. In addition, your doctor must state that you have six months or less to live. Hospice care is an important aspect of the end-of-life process to help a dementia patient and their family transition.

What’s Not Covered

Unfortunately, long-term care in a facility, like memory care, is not covered by Medicare. However, it can be very beneficial to people with dementia as well as their families, who may be struggling to care for them. There may be other resources available to help people who need to pay for long-term care. It’s also important to note that there are different coverage options available. For example, Medical Special Needs Plans are customized for people with dementia. To have a Special Needs Plan, you must also have Medicare Parts A and B.


Q: Does Medicare Cover Long-Term Care for Dementia Patients?

A: Medicare does not cover most aspects of the long-term care of dementia patients. It will not cover long-term care in assisted living facilities, nursing homes, or memory care facilities. However, it will cover hospice care when the patient has six months or less to live, according to a doctor. It can also cover up to 100 days in a skilled nursing facility and home healthcare for up to 35 hours a week.

Q: Does Medicare Cover Dementia Testing?

A: Yes, Medicare Part B can cover your normal annual visit to the doctor, during which your doctor can assess your cognitive function. If the doctor thinks you may have dementia, it can also cover a separate visit for your doctor to assess you more thoroughly and start a care plan.

Q: Does Medicare Cover Occupational Therapy for Dementia Patients?

A: If it is determined that occupational therapy is medically necessary for dementia patients, Medicare may cover it or part of it. Lakewood memory care can be beneficial for people with dementia; it may help them retain memory and function for longer. Medicare Part A will only cover inpatient occupational therapy if the patient is in an assisted living facility, hospital, or skilled nursing facility. For patients with Medicare Part B, outpatient occupational therapy is covered as well.

Q: Can You Get Disability for Memory Loss?

A: If you have memory loss, you may be able to get Social Security Disability benefits in certain cases. If your memory loss is minor, it is not likely that you will qualify. To receive SSDI, you’ll have to prove that your memory loss has impacted your daily life. You’ll need to show that your cognitive function has declined significantly.

Memory Care for Seniors With Dementia

Medicare can cover many services needed by those with memory loss. However, it doesn’t cover everything. It’s important to consider what works for your family’s financial situation after a dementia diagnosis. As the disease progresses, for many families, it may become impossible to meet the needs of a loved one with later dementia.

At this stage, memory care is often the right option. Even if you feel you’re not able to afford memory care, there may be resources that can help, like the Program of All-Inclusive Care for the Elderly or Medicaid. Rocky Mountain Assisted Living offers compassionate memory care that can provide comfort and quality care to those with dementia, as well as peace of mind for their families. Contact us today to learn more.