Transcript (Alzheimer’s and Medicare)

Alzheimer’s raises hard questions. Medicare helps with prevention, diagnosis, and some treatments. If you’re sorting this out for a spouse or loved one, you’re not alone. Over 12 million family members and friends in the U.S. provide care to loved ones with Alzheimer’s. Let’s look at medical services Medicare covers. 

The Medicare Annual Wellness Visit is once a year and includes a quick memory check. Should concerns arise, your doctor may suggest a Cognitive Assessment. Under Part B medical services, a deductible applies, followed by 20% coinsurance. Diagnosis may include visits with a neurologist, geriatrician, or neuropsychologist. When medically necessary, bloodwork, MRI and CT imaging may rule out other causes. To evaluate thinking and function, memory tests may be conducted. An amyloid P-E-T scan may detect amyloid plaques in the brain. If skilled care is needed. Part A may pay for limited skilled nursing rehabilitation. 

Skilled nursing coverage requires a hospital stay of at least three days. Home health may be offered if someone needs intermittent skilled nursing. Services under Part A maybe subject to a deductible and co-pay. Medicare does not cover custodial care. Custodial care is non-medical help with daily activities—like bathing, dressing, eating, or toileting. 

Medicare covers medically necessary physical, occupational, speech therapy and mental health care. Durable Medical Equipment—like walkers or wheelchairs may be covered as well. In 2024 C-M-S launched the GUIDE Model. The GUIDE model offers coordinated support to families with training and resources. Part D helps cover symptom medications like cholinesterase inhibitors, and memantine. Medicare Part B may cover infusions for those with early-stage Alzheimer's. Leqembi or 

Kisunla infusions are used for individuals with confirmed amyloid plaques in the brain. Infusions and monitoring usually follow under Part B cost sharing deductible, and then 20% coinsurance. Medicare doesn’t cover long-term custodial care, memory-care room and board, and 24-hour personal care at home. Families often use Medicare alongside Medicaid, veteran's benefits, or long-term care insurance to reduce costs.

Medicare Coverage depends on your doctor’s authorization and Medicare rules. Services must be medically necessary and meet current Medicare guidelines. A co-insurance, co-pays and a deductible may apply to Medicare Parts A, B, and D.

Alzheimer’s brings real challenges. Knowledge creates steadier ground. Medicare helps with prevention and diagnosis. Medicare may also cover treatments including home health care and certain infusions. Long-term custodial or memory-care housing isn’t covered. Planning ahead, reviewing benefits, asking providers about medical necessity, and exploring Medicaid or veterans’ programs—can reduce medical expenses. A well-defined plan enables families to focus on comfort, safety, and memorable experiences.