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Is Memory Care Covered Or Paid For By Insurance

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

If you have a loved one experiencing memory loss and/or the difficulties of Alzheimer’s disease or dementia, you may be starting to consider memory care. This specialized support can often bring a sense of relief and security to those facing memory loss as well as their families. We understand families may not know where to start when it comes to determining if insurance covers memory care – so here you’ll find some of the various factors to keep in mind.

For starters, it’s important to keep any existing health care or insurance plans active that may help meet your loved one’s care needs. Different insurance policies – including Medicare, private insurance, a group employee plan, retiree health coverage, disability insurance, veterans benefits or long-term care insurance – may contribute toward paying for care.

Different Ways Insurance Can Pay For Memory Care

  • Medicare: 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 – all after a standard yearly deductible. Medicare Part B covers partial fees for doctor’s services, outpatient care and other medical services not covered by Part A, as well as some preventive services. Medicare Part D covers some medication costs.
  • Medigap or MedSup: Supplemental coverage can be helpful if you have to rely on Medicare for assistance with dementia-related health bills. Plans and benefits widely vary but could help pay for Alzheimer’s and dementia care and related expenses so are worth considering.
  • Medicaid: Individuals with memory loss may qualify for medical care through Medicaid if they can demonstrate very low income and limited assets. Policies through Medicaid include coverage for long-term care for certain medical diagnoses.
  • Employee or Retiree Health Plan: It’s possible to be diagnosed with Alzheimer’s or other forms of dementia long before turning 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 provides income for a worker who can’t work due to illness or injury, but this type of plan would need to already be in place before symptoms of memory loss begin.
  • Veterans Benefits: Veterans and their spouses may be able to qualify for monthly benefits to help with the costs of memory care using Veterans Aid and Attendance. The process can take several months to complete, so it’s important to apply early through the Veterans Administration.
  • Long-Term Care Insurance: In order to take advantage of long-term care insurance, you already need to have a policy in place prior to diagnosis of dementia or Alzheimer’s. If you plan ahead, long-term care insurance can help pay for memory care – but be sure to compare how much a policy pays per day and how many days or years it will pay out.