Dementia is a harsh reality many seniors ages 65 and over face. Despite a name that sounds like an official clinical diagnosis, it actually isn’t. Dementia is an umbrella term for general cognitive decline that interferes with the ability to perform everyday activities. Deficits in decision making, cognition, and memory can impede your ability to live independently, leading to requiring professional assistance. Medicare will cover this.
Will Medicare Cover Dementia Testing?
Medicare offers a multi-faceted approach to dementia coverage, with variety in types of treatments and the stages during which they take place.
You don’t have to have dementia to get these dementia-related treatments, either. Medicare covers cognitive assessments for dementia regardless of your abilities.
How Does Medicare Cover Treatments Related To Stages Of Dementia?
If it turns out that you do have signs of cognitive decline, Medicare will also cover care planning. You will work with a professional to devise a strategy, including assessing whether your home is a safe environment.
Medicare will cover you for inpatient hospital stays, but it has limitations for the care you need at home. If you’re determined to be homebound, Medicare will cover up to 35 hours per week of home health services. Home health services are different from medical treatment. They’re designed to assist with daily living activities such as bathing, eating, and getting dressed.
What If I Need Nursing Home Or Hospice Care?
The services you’ll receive at a nursing home are similar to that of home health care. However, despite the similarities, Medicare doesn’t apply its coverage based on hours per week. Medicare typically covers the first 100 days of nursing home care.
Medicare offers a different coverage approach to hospice. While hospice includes personal care, it also features components involving care that only medical professionals can perform. It includes prescriptions, physician treatments, as well as counseling for patients and family members. However, Medicare only offers hospice coverage to individuals who have no more than six months to live.
Will Medicare Cover Medications For Dementia?
There is no one-size-fits-all for Medicare’s drug coverage. Medicare Part D is responsible for prescriptions, but plans vary because it’s only available through private insurance.
All Part D plans have their own formularies (list of covered medications) and rates for deductibles, coinsurance, and copayments. Some plans offer coverage within a network, which may only include certain pharmacies in your area.
Because of the differences between plans, it is best to compare the Part D plans available to you and see which one covers most (if not all) of the medications you’re currently taking.
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