Quick answer
No. Medicare doesn't pay for the room, board or daily personal care in a memory care community, because it doesn't cover long-term custodial care. It does cover medical care for someone with dementia: doctor visits, a cognitive assessment and care plan visit, hospital care, prescription drugs through Part D, short skilled nursing stays after a qualifying hospital stay, and hospice. Families usually pay for memory care privately or with help from Medicaid waivers, VA benefits or long-term care insurance. (800) 614-8388 to talk it through.
What Medicare does cover for dementia
| Service | Medicare coverage |
|---|---|
| Cognitive assessment and care plan visit | Part B; you pay 20% after the deductible |
| Doctor and specialist visits | Part B |
| Hospital stays | Part A |
| Prescription drugs | Part D plans |
| Short skilled nursing stay after a qualifying hospital stay | Part A, up to 100 days per benefit period, with daily coinsurance after day 20 |
| Hospice, when life expectancy is 6 months or less | Part A; room and board in a facility not covered |
What Medicare doesn't cover
- Rent, meals and daily personal care in memory care or assisted living.
- Long-term custodial care in a nursing home.
- 24-hour care at home.
How families pay for memory care
- Private pay: savings, income, sale of a home.
- Medicaid: in Kansas, the Frail Elderly waiver; in Missouri, waivers such as the Aged and Disabled waiver. These can help with care services for people who qualify, but usually not room and board, and not every community accepts them.
- VA: Aid and Attendance can add to a qualifying veteran's or surviving spouse's pension.
- Long-term care insurance, if your parent has a policy. See long-term care insurance.
- Tax deductions: some memory care costs may count as medical expenses. See tax deductions.
Worried about paying for memory care?
We'll walk through the options in Kansas and Missouri with you. Free.
Questions families ask
Does Medicare pay for memory care?
No. Medicare doesn't pay for room, board or custodial care in memory care.
Does Medicare Advantage cover memory care?
Medicare Advantage plans cover what Original Medicare covers and sometimes extras, but they don't generally pay for memory care room and board. Check the plan.
Does Medicare pay for a dementia diagnosis?
Part B covers a cognitive assessment and care planning visit. You pay 20% after the Part B deductible.
What pays for memory care if my parent runs out of money?
Medicaid may help with care costs for people who qualify. Ask communities early whether they accept Medicaid.