Does insurance cover or pay for memory care?

How To Find Insurance Coverage For Your Loved One With Memory Loss

If your loved one is living with memory loss, Alzheimer’s disease or dementia, you may be exploring memory care as an option. This specialized level of support can bring comfort and peace of mind — not only to the individual, but to the entire family. One of the first questions many families have is whether insurance will help cover the cost of memory care. It can feel overwhelming to know where to begin, so we’ve outlined a few important factors to help guide you through the process.

Learn How To Pay For Memory Care

First and foremost, keeping any existing health care or insurance plans intact is essential, as it may help meet care needs. Different insurance policies may help pay for care, including Medicare, private insurance, a group employee plan, retiree health coverage, disability insurance, veterans’ benefits or long-term care insurance.

Medicare: Many people do not realize Medicare does not pay for long-term care, outside of 100 days of skilled services or rehabilitative care for a qualified stay. Medicare Part A covers hospital stays, short stays in a nursing home for certain kinds of illnesses and hospice care in the last six months of life after a standard yearly deductible. Medicare Part B covers partial fees for doctors’ services, outpatient care, other medical services not covered by Part A, and some preventive services. Medicare Part D covers some medication costs.
Medigap or MedSup: A Medigap or Medicare Supplement plan may provide additional support if you rely on Medicare to help with dementia-related medical expenses. While plans and benefits can vary, Medigap coverage may help pay for certain costs associated with Alzheimer’s and dementia care that Medicare alone might not fully cover.
Medicaid: Memory care patients may qualify for medical care through Medicaid if they can demonstrate extremely low income and limited assets. Policies include coverage for long-term care.
Employee or Retiree Health Plan: It’s possible to be diagnosed with Alzheimer’s or other forms of dementia before you turn 65, in which case, private insurance through a group employee or retiree health plan may help pay for some expenses.
Disability Insurance: A disability policy could also provide income for a worker who can’t work due to Alzheimer’s or other forms of dementia, but the plan would need to be in place before symptoms of memory loss begin.
Veterans Benefits: Using Veterans Aid & Attendance, veterans and their spouses may be able to qualify for monthly benefits to help with the costs of care. The process can take several months, so applying early through the Veterans Administration is important.
Long-Term Care Insurance: To take advantage of long-term care insurance, you need to have a long-term care policy in place before the diagnosis of dementia or Alzheimer’s. If you plan ahead, long-term care insurance can help pay for memory care — be sure to consider how much a policy pays per day and how many days or years it continues to pay out.