Does Medicare Cover Dementia Home Care?

does medicare cover dementia home care
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For those aging adults living with dementia, the thought of having to leave home and enter a long-term care facility can be a terrifying and overwhelming experience. Fortunately, there are options for those who wish to remain in the comfort of their own homes. Home care is a great alternative to long-term care facilities, and many people are surprised to find out that Medicare does cover some dementia home care services. Medicare can cover a variety of services, from home health aides to hospice care, and knowing what is available can make a huge difference for those living with dementia.

What Is Dementia?

Dementia is a complex neurological disorder that is characterized by a gradual decline in cognition and memory. Over time, people living with dementia may experience confusion, impaired communication, and difficulty with everyday tasks. As the condition progresses, individuals may become increasingly dependent on caregivers for assistance with activities of daily living, such as bathing, dressing, and eating. Unfortunately, there is no cure for dementia, but there are treatments available that can help manage symptoms and slow the progression of the disease.

What Services Does Medicare Cover?

Medicare covers a variety of services for those living with dementia, including home health aides, skilled nursing, physical therapy, occupational therapy, and speech therapy. Medicare also provides coverage for medical equipment, such as wheelchairs, walkers, and hospital beds, as well as home modifications, such as grab bars for bathrooms, wheelchair ramps, and stair lifts. In addition, Medicare may cover hospice care for those who are nearing the end of their lives.

What Is the Eligibility Criteria for Medicare Coverage?

In order to be eligible for Medicare coverage, individuals must be 65 or older, or they must receive Social Security Disability Insurance (SSDI). Additionally, they must be enrolled in Medicare Part A, which covers hospital care, as well as Part B, which covers physician services and outpatient care. Furthermore, Medicare requires that individuals meet certain medical criteria, such as having a doctor certify that they are homebound and require intermittent skilled care.

What Are the Out-of-Pocket Costs?

Medicare typically covers 80 percent of the cost of home health care services, leaving the remaining 20 percent for the individual to pay out-of-pocket. Additionally, individuals may be responsible for paying monthly premiums, deductibles, and copayments for certain services. It is important to note that Medicare does not cover the cost of 24-hour live-in care, so individuals may need to seek out private insurance or long-term care insurance to cover this type of care.

Are There Other Options for Financing Dementia Home Care?

In addition to private insurance and long-term care insurance, there are other options for financing dementia home care. For instance, the Veterans Administration provides benefits for eligible veterans, and the state may provide assistance through Medicaid. Additionally, individuals may be able to receive assistance from family members, friends, and charitable organizations. Lastly, there are a number of private companies that offer home care services and accept payment from a variety of sources.


For those living with dementia, home care can be a lifesaver. Fortunately, Medicare does provide coverage for some home care services, including home health aides, skilled nursing, physical therapy, and hospice care. However, it is important to note that Medicare does not cover the cost of 24-hour live-in care, so individuals may need to seek out other sources of funding. Ultimately, there are many options for financing dementia home care, and it is important to explore all of them to find the best solution for each individual.

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