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Medicare Advantage Benefits For Alzheimer's and Dementia Patients

By Zawn Villines
Certain Medicare Advantage plans offer services and benefits for Alzheimer’s and dementia patients that Original Medicare doesn’t.

People living with Alzheimer’s and other dementias have complex medical needs. They may experience swallowing issues, depression, behavior problems, and progressively worsening confusion. Managing the medical costs associated with these illnesses can pose a serious financial burden to families, especially when a person with dementia can no longer safely live alone and needs 24/7 support. Fortunately, Medicare Advantage benefits may reduce out-of-pocket costs and provide additional care and support for these patients. Here’s how. 

Medicare Advantage for Alzheimer’s and Dementia Patients

The official U.S. government website for Medicare reports that Medicare Advantage plans offer the same benefits as Medicare Part A and Part B, including: 

  • Up to 100 days in a nursing home
  • Up to 35 hours a week of home health care for homebound people 
  • Most medical care, including regular visits with a doctor and hospital care for infections and other issues 

Additionally, the Centers for Medicare & Medicaid Services notes that, once Medicare Advantage beneficiaries begin receiving hospice care from a Medicare-approved provider, Original Medicare will cover all needs related to their terminal illness. These patients can retain their Medicare Advantage coverage as long as they continue to pay its premiums, and use either Original Medicare or their Advantage coverage for health issues unrelated to their terminal illness. 

Every Medicare Advantage plan is different, so it’s important to read the plan documents and compare the plans available in your state. Some additional benefits various plans offer include: 

  • Prescription drug coverage, including for dementia drugs 
  • Additional in-home care beyond the 35 hours per week original Medicare authorizes
  • Meal deliveries
  • Vision care
  • Dental care
  • Alternative and complementary care services such as acupuncture
  • Memberships at fitness clubs or gyms

With Medicare Advantage, there’s also an annual cap on out-of-pocket expenses. For people with dementia who have complex medical needs or advanced dementia, this can offer significant cost savings. 

Additionally, people with dementia may qualify for a Medicare Advantage Special Needs Plan (SNP). These plans offer customized benefits that cater to the needs of people with similar medical conditions, according to the Centers for Medicare & Medicaid Services. 

With an SNP, you or your loved one will have access to dementia specialists within a health network that specializes in dementia care. To get the most savings, you’ll need to stick with providers in that network. If you already have a doctor you like, ensure they’re covered under the plan. You can use the official U.S. government website for Medicare to look at the SNP options available to you. 

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