No, Medicare doesn’t cover the cost of living in a memory care community or long-term personal care home. It does, however, pay for some medical services and equipment related to dementia care. If your loved one with dementia has Medicare, it’s important to understand how Medicare works and what memory care services it does and doesn’t cover. This can help your family plan finances for memory care accordingly.
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Medicare doesn’t cover the cost of room and board in a memory care facility, but it may pay for some dementia care services provided in a memory care facility or at home. See what dementia care costs are covered in the table below.[01,02]
| Covered | Not covered |
|---|---|
| Cognitive assessments to confirm a dementia or Alzheimer’s diagnosis | The cost of rent in a memory care community or assisted living community |
| 100 days of skilled nursing care following a precipitating event, such as a hospital stay | Long-term memory care |
| Care planning and treatment option counseling | Long-term assistance with activities of daily living |
| Prescriptions to delay the progression of memory loss | Alternative therapies such as acupuncture or herbal medicines |
| Some custodial care services in certain situations |
Medical expenses can increase during the 12 months before an Alzheimer’s diagnosis.[03] This is because some early symptoms may cause confusion, often leading to more frequent doctor visits, diagnostic tests, and sometimes even emergency room visits. Therefore, an early diagnosis can help cover medical costs and reduce hospitalizations. A proper diagnosis can also help you take advantage of any services that can be billed to Medicare, especially screenings and preventive services.
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Yes, Medicare covers part-time home health care costs for dementia. If you’re considering home care for your loved one with dementia, keep in mind that homemaking tasks and assistance with activities of daily living, like bathing and toileting, aren’t covered by Medicare if that’s the only care they need.
Medicare only covers these custodial care services in combination with medically necessary home health services (like wound care or physical therapy). Furthermore, part-time home care is typically defined as care received less than seven days a week or less than eight hours each day over a span of 21 days.[04] For many families, Medicare’s home health care benefit isn’t a sufficient source of long-term assistance for a loved one with dementia.
No, Medicare doesn’t cover the cost of long-term nursing home care for seniors with dementia. However, Medicare may pay for some skilled nursing home care for up to 100 days under limited circumstances. One example might be if a senior with dementia has a qualifying inpatient hospital stay that warrants a limited stay in a skilled nursing facility afterward. Patients must need additional skilled nursing services like intravenous fluids or rehabilitative therapies.[05,06]
No, Medicare doesn’t cover assisted living for dementia patients. Assisted living communities fall under the same category as memory care communities. Medicare covers neither because these senior care options are considered long-term custodial care. Just like in memory care, Medicare can cover dementia-related medical services and equipment. This may include cognitive assessments, care planning, and some medically necessary custodial services.
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Because Medicare doesn’t pay for long-term memory care, families often find different ways to pay for memory care services. There are many surprisingly helpful ways to fund care, including veterans benefits, life insurance, and more.
Medicaid may also be an option. If you’re not sure whether Medicaid covers memory care facilities in your state, contact your State Medicaid Agency.
If you’ve decided to look for a memory care facility, reach out to one of our Senior Living Advisors. These experts can provide local guidance and help you find care that fits your loved one’s needs and budget, all at no cost to your family.
Dementia care typically refers to any dementia-related care services, such as cognitive therapies and medical treatments. Memory care typically refers to the long-term senior care option, which provides personalized dementia care in an assisted living community.
Yes, Medicare Advantage covers memory care costs, but only to a limited extent. These plans provide the same coverage as Original Medicare, which means it only pays for dementia-related services like cognitive assessments, care planning, and prescriptions for dementia symptoms.
Medicare classifies some care for dementia patients as nonmedical companionship because it doesn’t consider memory care or custodial care to be medically necessary.
Medicare.gov. Parts of Medicare. Medicare.gov.
Medicare.gov. Cognitive assessments and care plan services.
Lin, P., Zhong, Y., Fillit, H. M., Chen, E., & Neumann, P. J. (2016, June 13). Medicare expenditures of individuals with Alzheimer’s disease and related dementias or mild cognitive impairment before and after diagnosis. Journal of the American Geriatrics Society.
U.S. Centers for Medicare and Medicaid Services. Home health services. Medicare.gov.
U.S. Centers for Medicare and Medicaid Services. Nursing home care. Medicare.gov.
U.S. Centers for Medicare and Medicaid Services. Skilled nursing facility (SNF) care. Medicare.gov.
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