Alzheimer’s Care and Medicare: What You Need to Know

Last Updated: January 28, 2019

Medicare is a federal health insurance program that covers “medically-necessary” costs, but the term can be confusing when it comes to eligibility for long-term care for people with Alzheimer’s disease in the United States.Alzheimer's Care and Medicare: What You Need to Know

Does custodial care fall under a “medically necessary” expense? Learn more about Alzheimer’s care costs and Medicare.

Alzheimer’s Costs and Medicare

Alzheimer’s caregivers are no strangers to the costs of the disease. Alzheimer’s has devastating emotional and physical costs, but its financial costs are putting many families into medical debt. According to the 2018 Costs, Accountabilities, Realities and Expectations (C.A.R.E.) Study, the average Alzheimer’s care cost in 2018 was $273 per month, with 67% of caregivers polled reporting reducing their own living expenses to pay for costs associated with the disease.

The Alzheimer’s Association also estimates that the disease will cost the nation $277 billion this year, with costs growing to $1.1 trillion by 2050.

Unfortunately, regardless of the rising costs of Alzheimer’s, long-term care for people with the disease is usually considered an issue of custodial care, and thus, not covered under Medicare.

Custodial Care vs. “Medically Necessary” Care

According to Linda Adler, CEO and Founder of Pathfinders Medical, a patient advocacy group, if the care is not considered “medically necessary” it will not be covered by Medicare.

Most people with Alzheimer’s need what Medicare calls “custodial care.” This kind of care is non-medical and aids the patient with cleaning, dressing, eating and other activities of daily living (ADLs). Adler says:

“There was a time when the family could come together and care for seniors at home. But families now are different in many ways, and often when patients are in need of basic care, they are unable to get it from traditionally available sources.”

How to Plan for Future Care Costs

The disconnect between care needed and care covered can cause financial trouble and stress for families coping with an Alzheimer’s diagnosis. Adler suggests considering options and making plans before long-term care becomes a necessity.

“People need to understand long-term care insurance and Medicare, as well as the different types of coverage available and the different housing options within their communities.”

Other options for families include Medicaid for low-income patients or private health insurance. Whatever option families choose should be planned for before the needs arise, giving families time to find the best and most affordable option for a parent or senior loved one. 

Are you a caregiver to a senior loved one? How do you cover long-term care costs associated with Alzheimer’s? We’d like to hear your stories in the comments below.

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Please leave your thoughts and comments

  • Sloan

    If we’d stop giving all the freebe,s to all the illegal aliens and con artists and Obama stop giving our money by the billions to his Islamist cult pals and start taking care of the Amereican people who pay taxes to be cared for.Get rid of this corrupt Government and Obama death care and the big health company,s stop ripping the people off we’d be in great shape in a few years ,i think so anyway.

  • Matt

    Yes it should. Familes save their whole lives just to have it whiped out because of the term “Medically Necessary”. To ALZ and Demitia patients and their families. It is medicaly needed.

  • CasyK

    What a horrible country we live in. It doesn’t make sense to work hard all your life and pay taxes and in the end if you get dementia or Alzheimer’s you are literally screwed. If you have too much money you end up going broke, if you have no money you get care but what is the quality of the care? I am very disappointed in this country and how the elderly are treated. My Mom was on hospice and after 6 months they bailed on her.. my Dad refuses to go into assisted living he has to pay care takers to come in but she is not getting proper care.. he is 97 she is 95 the family helps but everyone has their own lives and it isn’t fair that elderly have to struggle to survive after a long hard life. My dad served in WWII and VA is only worried about him paying for healthcare and anything he needs.. This country is screwed up big time. The politicians priorities are self motivated. SO sad!

  • Gardengirl

    My father served in the Korean war, while mom worked until retirement and developed Alzheimer’s . Cant affird a nursing home while illegals get it paid for,,,fact. Thankyou democrats.

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