What Benefits does Medicare Provide for Alzheimer’s Patients?

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What benefits can someone expect from Medicare for someone diagnosed with Alzheimer’s? In addition to the emotional burdens and concerns an elderly loved one’s Alzheimer’s disease may bring about, financial considerations come to the fore too. Fortunately, there are many resources out there to help people facing this situation.  Medicare has benefits available to people in the early, middle, and late stages of Alzheimer’s. It is important to know what to expect at each stage. This enables the best coverage and care for someone suffering from Alzheimer’s.

In addition to the emotional burdens and concerns an elderly loved one’s Alzheimer’s disease may bring about, financial considerations come to the fore too. Fortunately, there are many resources out there to help people facing this situation.  Medicare has benefits available to people in the early, middle, and late stages of Alzheimer’s. It is important to know what to expect at each stage. This enables the best coverage and care for someone suffering from Alzheimer’s.

Help in the Early Stages of Alzheimer’s

In the early stages of Alzheimer’s, an elderly person will still be largely capable of performing basic self-help tasks.  While the person may have difficulty remembering words, performing math problems, or locating items, special care is usually unnecessary.

Nevertheless, a doctor will need to rule out other causes of the above symptoms. The elderly person will need to undergo testing and evaluation for a formal diagnosis of Alzheimer’s. Medicare will cover 80% of the cost of such testing and evaluation if the deductible is met.

After an Alzheimer’s diagnosis, other expenses will occur.  Medicare will pay for 80% of most medically necessary items, such as counseling, medication, and physical therapy.  In addition, Medicare supplemental insurance is available to cover the other 20%. This will increase the elderly person’s options when it comes to medications.

Help in the Middle Stages of Alzheimer’s

As the disease progresses, the person’s symptoms will increase in severity. Medicare will continue to cover certain medications and visits to the doctor. Medicare does not cover alternative therapies like herbal medicine, acupuncture, or similar therapies.  Further, in the event that an elderly person in the middle stages of Alzheimer’s needs assistance with personal care or supervision, Medicare does not cover these expenses.

Help in the Late Stages of Alzheimer’s

As the disease continues to worsen, the patient will come to need close supervision 24 hours a day.  Medicare can help with home health care for elderly people who have been certified as homebound. This only extends to 35 hours per week, however. If an elderly person is hospitalized and has to go into a nursing home, Medicare will help. Medicare will pay for up to 100 days of nursing home care.

Once the disease progresses to its final stages, Medicare will pay for hospice care once a doctor has determined that the elderly person has less than six months to live. These payments will cover all doctor and nurse visits, medications, and homemaker services. In addition, Medicare will pay for counseling for both the victim of the disease as well as his or her family. This can be very helpful to everyone involved. The process of letting go and accepting a terminal diagnosis can be very difficult for everyone in the family.

It Is Best to Plan in Advance

It is good to be aware of the help available from Medicare. However, most services are capped at 80%. This leaves the patient responsible for the other 20% of the cost for each treatment. The extra cost includes medication or the assistance of any medical personnel. Even at 20%, treatment can quickly become prohibitively expensive. Thus, it may be a good idea to explore supplemental insurance ahead of time. In the event that an elderly person does develop Alzheimer’s, the insurance is well worth the premiums.

Supplemental insurance and long-term care insurance can mean everything to patients. Family members of elderly persons do well to explore options at the earliest opportunity. Doing so will ensure all the care an elderly person needs. It also prevents family members from falling into irrecoverable debt.

Sources

Gutterman, E.M., Markowitz, J.S., Lewis, B., Fillit, H. (September 1999). Cost of Alzheimer’s Disease and Related Dementia in Managed-Medicare.  Journal of the American Geriatrics Society, 47(9): 1065-71.

Newcomer, R. J., Clay, T. H., Yaffe, K., Covinsky, K. E. (November 2005). Mortality Risk and Prospective Medicare Expenditures for Persons with Dementia. Journal of the American Geriatrics Society, 53(11): 2001-6.

 

Social Security Administration. Available at https://www.ssa.gov/. Retrieved September 15, 2016.

 

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