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Medicare Alzheimer’s Treatment Coverage: What Benefits Are There for Cognitive Decline Patients?

"Medicare Alzheimer's Treatment Coverage: What Benefits are There for Cognitive Decline Patients?" text over image of Alzheimer's patient going through memory book

Alzheimer’s treatment can be very expensive. A Medicare plan can help you cover the costs. Call us today at (800) 950-0608 to find a Medicare plan that helps you get the coverage you need for Alzheimer’s treatment.

Just the Essentials:

  • Medicare covers most treatments and services considered medically necessary for Alzheimer’s disease.

  • Certain Alzheimer’s medications are not fully covered by Medicare prescription drug plans.

  • Medicare Advantage (Part C) plans may cover more treatment options than Original Medicare (Part A and Part B).

When “Typical Aging” Slides Into Cognitive Decline

Your partner was just talking about an old friend a few seconds ago. You can barely remember what they were talking about.

You’ve made apple pie in a very specific way for many years without a recipe. Remembering the steps was so easy the last time you made it. Today, you can barely remember how much sugar goes in the filling.

Maybe you’re even forgetting where you put your keys most of the time, or you need a reminder of which day of the week it is. All of these things may sound like common issues that come with aging. However, they could also be warning signs of cognitive decline.

In the last few decades, cognitive issues like Alzheimer’s disease have become more prevalent in the senior population. As of this writing, it’s estimated that more than 6 million Americans aged 65 or older are currently living with Alzheimer’s. According to the National Institute on Aging, Alzheimer’s is the seventh leading cause of death among seniors.

Fortunately, advances in medical science in recent years have yielded methods of Alzheimer’s treatment that have been successful in slowing the progress of the disease. For instance, Aduhelm, a new Alzheimer’s medication developed by Biogen, has been shown in some studies to reduce or eliminate the buildup of amyloid plaques in the brain that are thought to cause Alzheimer’s. Other treatment options, from therapy to prescription drugs, designed to help seniors affected by Alzheimer’s retain much of their remaining cognitive abilities are available as well. 

The unfortunate reality, however, is that treatment for Alzheimer’s disease can be incredibly expensive. As many seniors are on low fixed incomes, affording much-needed Alzheimer’s disease treatment can be a major issue. If you can’t cover the costs of Alzheimer’s treatment on your own, will Medicare cover the cost? Let’s find out.

Does Medicare Cover Alzheimer’s Care?

Treatment for Alzheimer’s disease can be costly. Because Alzheimer’s treatment can be expensive, you may be wondering, “Does Medicare cover Alzheimer’s care?”

Fortunately, if you’re enrolled in Medicare, most treatments and services for Alzheimer’s are covered. As long as the services or treatments are deemed medically necessary, Medicare will help you pay for them. This includes services or treatments for diagnosis and prevention of Alzheimer’s.

If you have Original Medicare, Medicare Part A and Medicare Part B, you’ll find that a majority of treatments and services you may need to treat Alzheimer’s, inpatient and outpatient, are covered. Here’s a breakdown of some of the Alzheimer’s treatment methods that are covered by Original Medicare:

Medicare Part A:

  • Inpatient hospital and skilled nursing facility stays*
  • Medications and therapies needed during hospitalization
  • Home health services*
  • Hospice care

Medicare Part B:

  • Screenings and diagnostic services
  • Visits to your doctor or specialist
  • Physical, occupational, or speech therapy
  • Mental health services (both inpatient and outpatient)
  • Necessary medical equipment

*Coverage for inpatient stays or home health with Medicare Part A is limited. For instance, Part A will only cover short-term hospital or skilled nursing facility stays (typically up to around 190 days).

Medicare Advantage and Medicare Prescription Drug Coverage Can Add Support for Vital Medications and Services

While Original Medicare covers most available Alzheimer’s treatments and services, it doesn’t cover everything. For instance, Medicare Part B offers coverage for outpatient medications that are administered by a medical professional. It will not cover other general prescription medications. It also will not cover certain other services needed by many seniors. This is where Medicare Part C, also known as Medicare Advantage, and Medicare Part D Prescription Drug coverage can help.

Medicare Advantage provides coverage for all Alzheimer’s treatment services covered under Original Medicare. It also provides coverage for additional services that help seniors with cognitive issues maintain good health and hygiene. In addition to treatment for Alzheimer’s disease, Medicare Advantage plans often cover:

  • Dental care
  • Hearing and vision care
  • Fitness and wellness services
  • Medical supplies
  • Transportation to and from medical appointments

Medicare Part D plans will cover most prescription medications formulated to help combat the effects of Alzheimer’s. There are some prescription medications that your Part D plan may not cover, or for which there are restrictions in place. One such medication is Biogen’s new Alzheimer’s medication, aducanumab, which is also known as Aduhelm.

Medicare has limited coverage of Aduhelm to beneficiaries who have been accepted into clinical Phase III studies for the medication. These patients tend to be healthier than other beneficiaries who otherwise would have access to Aduhelm.

Don’t Let a Lack of Funds Hold You Back From Getting the Alzheimer’s Treatment You Need

Many seniors who are on fixed incomes cannot afford the cost of treatment for cognitive illnesses that affect them, such as Alzheimer’s. If you don’t receive much in the way of income, it can feel like an uphill battle trying to pay for the Alzheimer’s treatment you need to slow the progress of the disease. It doesn’t have to be.

Medicare plans are available that can help you cover the costs of your Alzheimer’s disease treatment. Our friendly, experienced, licensed agents are here to help you find a Medicare plan that meets your needs. Give us a call today to learn more about available Medicare plans in your area.

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