Does Medicare Cover Memory Care Facilities?

Understanding whether Medicare covers memory care facilities can be confusing, especially for those dealing with conditions like Alzheimer’s or dementia. Let’s break it down in simple terms.

Medicare is a federal health insurance program primarily for people aged 65 and older. It covers a wide range of medical services, but its coverage for memory care facilities is limited. Generally, Medicare does not pay for stays in memory care facilities, even if you have dementia or Alzheimer’s disease. This is because Medicare primarily covers medical services rather than custodial care, which is what most memory care facilities provide.

However, there are some exceptions. Medicare can cover certain skilled care services, such as cognitive therapy, if you are in a skilled nursing facility (SNF) following a hospital stay. For example, if you’ve been hospitalized for at least three days and then need skilled care, Medicare can cover the full cost of that care for the first 20 days in an SNF. After that, it covers 80% of the costs up to 100 days. But this is not the same as paying for a memory care facility stay.

If you need long-term care in a memory care facility, you might consider other options. Medicaid, for instance, can cover nursing facility services, which include memory care, but eligibility depends on your income and resources. Some people are dually eligible for both Medicare and Medicaid, which can provide more comprehensive coverage.

In summary, while Medicare does not typically cover stays in memory care facilities, it can cover specific skilled care services under certain conditions. For ongoing memory care, exploring Medicaid or private insurance options might be necessary.