How Much Does Medicare and Medicaid Cover Memory Care?

How Much Does Medicare and Medicaid Cover Memory Care?

October 1, 2018

Senior healthcare insurance is perhaps one of the most important things to keep track of as you approach the age of retirement. The truth is, these insurance plans can get tricky and technical. However, by keeping yourself updated with the basics and the latest changes in health insurance plans, you can make the most of them.

There are two main healthcare plans that the government of the United States facilitates its citizens with, Medicare and Medicaid. Catering to over 73.5 million people across the US and having enrolled 16 million more in May 2018, the federal spending on these healthcare plans has been increasing over the last three decades. Although the eligibility criteria and the scope of benefits for both these health care plans is different, Medicare and Medicaid play a big role in helping out people nearing and of the age of retirement receive the best possible health care options.

Even with the recent budget cuts on Medicare spending, this governmental health insurance program is still accessible to many US citizens. The only thing that people nearing the age of 65 need to keep track of is to enroll into the program on time to ensure they have access to Medicare benefits. Among other health care coverage plans, Medicare and Medicaid also cover memory care.

Medicare, Medicaid and Coverage for Memory Care

Knowing the kind of coverage these programs provide and the scope of the coverage, you can choose best the type of senior living facility that offers the memory care needs you may be looking for.

Medicaid and Memory Care

Medicaid is a social protection program that caters to seniors with limited resources and low incomes. A Medicaid provision includes recipients of Medicare and is solely for those who meet the low-income criteria. The Medicaid office in your state decides who becomes a beneficiary in terms of eligibility. This includes checking for eligibility of receiving memory care coverage.

Each state decides its own terms for offering Medicaid to the receivers. This is why it’s important to understand the laws of the particular state in which the senior needing memory care resides. While some states offer Medicaid coverage for people diagnosed with Alzheimer’s and other forms of dementia, others only grant Medicaid benefits to those needing memory care at home and not to those living in assisted living facilities.

For this reason, it is always best to check with the facility you are considering and ask them if they accept Medicaid payments for their memory care services.

Medicare and Memory Care Coverage

Unlike Medicaid, Medicare does not provide the same scope of coverage or benefits for memory care. This comes as a surprise to many individuals seeking coverage for long-term memory care facilities.

According to the Alzheimer’s Association, Medicare covers up to 100 days of skilled nursing homes and that too in a limited capacity. Medicare does not cover long-term memory care.

Moreover, Medicare provides coverage for hospice care within a patent’s home, a nursing or hospice facility for dementia patients nearing the end of life, according to their doctors. Medicare, however, does cover a portion of the costs incurred for cognitive assessments of Alzheimer’s patients.

What Are Some Alternate Payment Options for Memory Care Coverage?

Medicare supplement plans work to fill in the gap that Medicare plans have. If a person needing memory care coverage has Medicare Part C, they can get in touch with their Medigap provider and ask them if the company provides coverage for memory care services.

Another option could be to reach out to a case manager to discuss options. Moreover, you can also seek help from your hospital discharge planner or social worker. These people will be able to guide you toward options or plans that can help you out.

In most cases, they have resources for programs and facilities that can help seniors, who are unable to afford the full cost of memory care, find the memory care services they need.

Need Help Looking for Senior Living Facilities Offering Memory Care?

Taking care of a loved one suffering from Alzheimer’s and dementia can take its toll on caregivers. Sometimes, we have to end up making a difficult choice but one that will help our loved ones get the care they need and deserve. If you are looking for memory care facilities in the Kansas City metropolitan area, get in touch with Ralph Caro.

Ralph Caro is an elder care consultant and certified Senior Care Advisor, committed to helping you and your loved ones find options for a safe and comfortable memory care option that suits your budget.

Having been a part of senior care for more than three decades, Ralph Caro specializes in senior placement for Alzheimer’s and dementia care. Contact Ralph Caro today to make an informed decision.