A question we often hear from families who need to find memory care for their senior is: “Is memory care covered by Medicare and Medicaid?” The answer is not always that simple unfortunately. This article explores memory care coverage for seniors in more detail.
Memory care facilities can offer a safe and unique environment for someone with memory care needs. Memory care facilities differ from other types of senior care as they include 24-hour attendance, specialized staff, memory-enhancing therapies, a secure environment, and more. If you or a loved one needs memory care, knowing your medical rights and health care coverage options is an integral part of the process. To budget for future memory care, you’ll need to establish out-of-pocket costs to assist you in the long run. There are many resources to guide you along the way. Here we discuss whether memory care is covered by Medicare and Medicaid.
What Medicare Covers
Memory care falls under Medicare’s long-term care, which is also known as custodial care. Medicare covers some medical costs related to memory but not all. As a result, the out-of-pocket costs can be high and increase assisted living costs dramatically. Here are some memory care services covered by Medicare:
- Cognitive impairment assessment
- Diagnosis
- Person-centered planning services
- Annual Wellness Visits
- Up to 100 days of skilled nursing care, privately or in assisted living facilities.
- Hospice care for pain relief and end-stage dementia
- Home health care
- Inpatient care for clinical research studies
Medicare comes with out-of-pocket costs such as coinsurance, co-payments, and deductibles. Prescription medications are also not covered by Medicare. However, Medicare is thankfully not your only option. Medicare also contracts with private insurance companies that may aid in reducing these staggering costs. Here are good options to consider:
- Medicare Supplement Insurance (Medigap)
- Medicare Specials Needs Plans
- Medicare Part C
- Medicare Part D
For more details regarding these costs, please visit Medicare’s Medicare Costs at a Glance.
What Medicaid covers
Medicaid assists lower-income individuals with limited financial resources. Factors taken into consideration are family size, disability status, and age. Memory care falls under the nursing facility services, covered by Medicaid.
The flip side is that how memory care is delivered may vary by state. For example, some states provide long-term care in the home or within a Medicare-approved facility, while other states may only provide you with one option. For more information on memory care in Arizona, please visit Memory Care.com.
Here are services offered by Medicaid:
- Prescription drugs
- Physician services
- Outpatient hospital services
- Inpatient hospital services
- Early and periodic screening
- Diagnostic and treatment services
- Home health services
- Laboratory and X-ray services
- Transportation to medical care
Covering the cost of memory care
Ask for assistance from your hospital discharge planner or care coordinator. They can advise what resources or facilities you can use if you can’t afford the additional costs.
Require further assistance on how to plan for memory care financially? Franklin Park has helpful Tips For Saving for the cost of memory care.
Finding Medicaid and Medicare memory care services near you
Memory care facilities have grown due to the increasing number of individuals requiring these assisted living services. This increase has resulted in the long-term care industry evolving to include unique and different services to accommodate different levels of needs.
Deciding on an assisted living facility for memory care can be overwhelming. Contact us. We can help you by connecting you to the best assisting living facility near you that matches your financial needs.
Conclusion
Costs of memory care depend on you or your senior’s needs. Start planning immediately once a diagnosis has been made. Early planning can reduce out-of-pocket costs and help you decide on the best level of care required. Are you moving to a memory care facility? Visit our article for helpful information on what to expect.
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