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Medicare is a federally financed health insurance program for citizens and legal residents of the United States. They are at least 65 years old or have a qualifying sickness or disability, such as permanent kidney failure. Medicare is divided into distinct sections that cover a variety of different services. It is divided into four sections: A, B, C, and D of Medicare.

memory care facility

Medicare Part A:

Inpatient hospital care, skilled nursing facility care, nursing home care, hospice care, and home health care are all covered.

Part B:

Medicare covers essential medical services such as outpatient care, occupational therapy, medical equipment, and testing. Additionally, preventative care such as physical exams and cancer screenings are included.

Part C:

Also known as Medicare Advantage, Medicare helps pay for prescription medications, vision and dental insurance, and mental health services.

Medicare, Part D:

In exchange for a monthly premium, Part D offers access to the pharmacy network of an external insurance provider.

Although most eligible persons are enrolled automatically in Medicare Parts A and B, others must enroll manually through the Social Security Administration. Individuals who have paid enough in Social Security and payroll taxes may be exempt from paying the Medicare Part A premium; however, you may have to pay out of pocket if you do not have enough tax credits. Premiums for Medicare Parts B, C, and D vary according to the level of coverage selected. Further, you can also contact dementia facilities near me.

Memory Care’s Financial Impact

Memory care is approximately 20% to 30% more expensive than assisted living, depending on the location, quantity of amenities, and type of programming the memory care institution offers. According to the 2019 Genworth Cost of Care Survey, assisted living costs average $4,051 per month in the United States. We added 25% to the cost of assisted living to determine the average monthly cost of memory care in the United States; memory care costs approximately $5,064 per month.

While memory care is frequently given in assisted living facilities and offers similar personal care services and amenities, memory care costs more than assisted living because it requires specialized staff training, treatment, and programming, as well as facility design and security. Does Medicare pay for memory care facilities?

When Will Medicare Cover Memory Care Facility or Will It Not?

Medicare pays a portion of the cost of care at a memory care center and facility, but not all of the prices. It excludes long-term care but includes the following:

Additional Financing Options for Alzheimer’s Care

There are numerous financial resources available to individuals who require assistance with the cost of memory care:

Private groups: Community organizations, such as a local Alzheimer’s society, may offer programs to assist qualified individuals with the cost of memory care. Financial aid may also be available through a local church or volunteer group.

Is Memory Care Covered Under Medicare’s Facility-Based Long-Term Care Benefits?

For a substantial majority of seniors, Medicare is their primary source of medical insurance. Many people are surprised to learn that Original Medicare (Medicare Parts A and B), also known as Traditional Medicare, does not cover most long-term care costs, including Alzheimer’s and dementia care. When it is profitable, it is in a minimal capacity. While traditional Medicare is not a long-term care option, it does provide short-term benefits for seniors with treatable diseases. Additionally, as previously stated, specific Medicare Advantage Plans (Medicare Part C) now include some in-home and community-based long-term care benefits in certain circumstances.

Nursing Homes for the Sick

Medicare covers 100% of the cost of care in a skilled nursing facility for the first 20 days and around 80% of the price for the next 80 days. Care must be provided in the aftermath of an inpatient hospital stay.

Communities for the Elderly

Medicare does not cover any of the costs associated with assisted living facilities. It will cover most medical expenses incurred while the senior is in assisted living, but not custodial care (personal care) or the assisted living facility’s room and board fees. Specific Medicare Advantage plans may cover personal care for individuals dwelling in assisted living or memory care, but not room and board.

Medicare will fund skilled nursing care in the home for a short period, but not non-medical care. Care must be prescribed by a physician and is only required temporarily. The senior must be “contained,” which means they must be unable to leave the house without assistance from another person. This is referred to as being “homebound” in the formal sense. However, specific Medicare Advantage plans may offer non-medical in-home personal care support.

Care for Adults

Adult daycare services are not covered by Original Medicare, although some Medicare Advantage plans may pay for them.

Alzheimer’s / Dementia 

Regrettably, most care associated with Alzheimer’s disease is classified as personal care and hence not covered by Medicare. Nevertheless, specific Medicare Advantage plans may cover the expense of in-home care. Original Medicare and Medicare Advantage cover medical care linked with Alzheimer’s disease. A hospice benefit is available to Medicare beneficiaries in the highly late stages of Alzheimer’s disease. Continue reading to learn more about Alzheimer’s care financing.


Medicare covers hospice care for terminally ill patients who have less than six months to live, as determined by doctors. While Medicare hospice typically does not cover room and board, it does cover medical bills, prescription medicines, and homemaker services that Medicare does not cover. While hospice care is typically provided at the patient’s residence, inpatient treatment is an option.

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