Medicare alone often is not enough to fully cover the costs of Alzheimer’s medications, though it does provide some important support. Alzheimer’s disease requires ongoing treatment with prescription drugs that can be expensive, and Medicare’s coverage of these medications depends largely on the specific plan and the type of Medicare coverage a person has.
Medicare Part A and Part B, the original Medicare components, generally do not cover most outpatient prescription drugs, including many Alzheimer’s medications. Part B covers drugs administered in a clinical setting, such as certain infusions, but Alzheimer’s medications are usually taken orally at home, so they fall outside Part B’s scope. This means that for most Alzheimer’s medications, coverage comes primarily through Medicare Part D, which is the prescription drug benefit.
Medicare Part D plans are offered by private insurers approved by Medicare and cover a wide range of outpatient prescription drugs, including many used to treat Alzheimer’s disease. However, coverage varies by plan because each plan has its own formulary—a list of covered drugs—and rules about copayments, coinsurance, and prior authorizations. Some Alzheimer’s drugs may be on the formulary, but others might not be, or they may require special approval or higher out-of-pocket costs.
Even with Part D coverage, patients often face significant expenses. There is an annual out-of-pocket spending limit, which in 2026 is capped at $2,100, after which Medicare covers 100% of covered Part D drug costs for the rest of the year. Before reaching this limit, patients pay premiums, deductibles, and copayments or coinsurance, which can add up, especially for costly Alzheimer’s medications.
Medicare Advantage plans (Part C), which combine Parts A, B, and usually D, sometimes offer additional benefits that can help people with Alzheimer’s. These plans may cover extra services like home health care, caregiver support, transportation to medical appointments, and safety improvements at home, which are crucial for managing Alzheimer’s but are not covered by original Medicare. Some Medicare Advantage plans also provide more comprehensive drug coverage or lower out-of-pocket costs for Alzheimer’s medications, but benefits vary widely by plan and location.
Medication Therapy Management (MTM) programs are another Medicare feature that can benefit Alzheimer’s patients. These programs help patients manage complex medication regimens, improve adherence, and reduce adverse effects. To qualify for MTM, patients typically must have multiple chronic conditions, take several medications, and meet certain cost thresholds. Alzheimer’s disease i
