There may be some confusion as to what Medicare covers and what they don’t cover for those in Memory Care. There may be even more confusion as to what Medicare covers and what Medicaid covers. In this blog post, we will discuss, specifically, what Medicare will pay for. In a separate blog, we will discuss with Medicaid covers, but at this point, Cherished Transitions wants this process to be as easy as possible, without confusion. So, what does Medicare cover?
If your loved one has Alzheimer’s or dementia and is in fact a Medicare beneficiary, Medicare will pay for some care costs. Let’s take a deeper look at what those covered costs include.
For those with Alzheimer’s or dementia who are over the age of 65, Medicare Part A covers inpatient hospital care and some of the doctors’ fees and other medical items. There is an option to enroll in Medicare’s Part D prescription drug plan, which also covers many prescription drugs.
Medicare Part A (Hospital Insurance) covers skilled nursing care provided in a skilled nursing facility under certain conditions for a limited time (up to 100 days). Those services include: Semi-private room, meals, skilled nursing care, physical and occupational therapy, speech-language pathology services, medical social services, medications, medical supplies and equipment used in the facility, ambulance transportation, and dietary counseling, as well as swing-bed services (in certain hospitals).
Medicare Part A will pay for hospice care delivered in the home, a nursing facility or an inpatient hospice facility for people with dementia who are determined by a hospice or regular doctor to be terminally ill. Medicare includes services such as doctor’s services, nursing care, medical equipment and supplies, prescription drugs for pain relief, hospice aid, physical and occupational therapy, speech-language pathology services, social work services, dietary counseling, grief and loss counseling for you and your family, short-term inpatient care, and short-term respite care.
Medicare does cover more specific areas for Alzheimer’s, dementia or cognitive impairment, especially when it comes to care planning or those with special needs. Following a diagnosis, those with Alzheimer’s will have access to care planning with a medical professional, which will improve their outcome as well as their quality of life.
There are Medicare Advantage plans that specialize in care and coverage for beneficiaries with Alzheimer’s disease, including dementia called Special Need Plans (SNPs). Only Medicare beneficiaries with dementia can enroll in these plans.
Please visit medicare.gov to provide information about Medicare, open enrollment, benefits and how to find Medicare plans, Kansas City area facilities or providers.