Medicare does not generally cover the full cost of memory care facilities, especially the room and board expenses associated with long-term custodial care. Memory care is a specialized type of assisted living designed for people with Alzheimer’s disease, dementia, or other cognitive impairments, providing 24-hour supervision, safety features, and tailored programming. While Medicare covers some medical and skilled nursing services related to memory care, it does not pay for the housing or non-medical custodial care that memory care facilities provide.
Medicare coverage for memory care is limited primarily to medical services that might be needed by someone with dementia. For example, Original Medicare (Parts A and B) can cover cognitive assessments, diagnosis, and care planning, as well as inpatient hospital stays if the person is treated for an illness or injury. Medicare Part A may cover up to 100 days of skilled nursing facility care if certain conditions are met, such as a qualifying hospital stay beforehand. Medicare also covers home health care services if the patient is homebound and requires skilled nursing or therapy, and hospice care for end-stage dementia to manage pain and symptoms. Durable medical equipment and some clinical research inpatient care may also be covered. However, these benefits do not extend to paying for the daily supervision, assistance with activities of daily living, or housing costs in a memory care facility.
Medicare Advantage plans (Part C) have introduced some improvements for people with dementia. These plans may offer additional benefits under the Special Supplemental Benefits for the Chronically Ill (SSBCI) program, which can include services like home-delivered meals, transportation to medical appointments, and home safety modifications. Medicare Advantage plans may also cover some services that help reduce the overall cost of living in an assisted living or memory care community, but they still do not cover the full cost of room and board.
For long-term memory care costs, Medicaid is often the primary public program that can help, but eligibility and coverage vary by state. Medicaid may cover memory care if it is provided in a nursing home or a specialized dementia unit within a nursing home, and if the individual meets strict financial and medical criteria. Medicaid does not typically cover memory care in assisted living facilities unless the state has specific waivers or programs. Long-term care insurance, if purchased before the onset of dementia, can also help cover memory care costs, but these policies must be in place well before care is needed.
Because Medicare does not cover the full cost of memory care, families often face significan
