Medicare Coverage for Alzheimer's & Dementia: What's Included in 2026
Quick Answer
Medicare covers diagnosis, doctor visits, cognitive assessments, and some treatments for Alzheimer’s and dementia, but it does not cover long-term custodial care like assisted living or full-time memory care.
Medicare covers the medical side of Alzheimer’s and dementia — testing, doctor care, medications, and even newer treatments — but the biggest cost, long-term custodial care, falls outside Medicare. Planning early for that gap matters.
What Original Medicare Covers for Alzheimer's & Dementia
Part AHospital Coverage
- Inpatient hospital care and short-term skilled nursing after a qualifying stay
- Hospice care for end-stage dementia
Part BMedical Coverage
- Cognitive assessment and a care-planning visit
- Doctor visits and diagnostic testing, including PET scans when criteria are met
- Newer anti-amyloid Alzheimer’s treatments when coverage criteria are met
- Dementia care management support (the GUIDE model)
Part DPrescription Drugs
- Medications such as donepezil and memantine
- Other prescription drugs used in dementia care
What Medicare Advantage May Add
Benefits vary by plan, county, and year. The items below are common but not guaranteed — always confirm in the plan’s Summary of Benefits.
- Care coordination and caregiver support on some plans
- In-home support, adult day services, and transportation benefits
- Chronic-condition Special Needs Plans (C-SNPs) for dementia (varies by plan)
What Is NOT Covered
- Long-term custodial care
- Assisted living room and board
- Full-time memory care facilities
- Homemaker services such as cleaning and shopping
What You Can Expect to Pay
Covered medical services
20% coinsurance after the Part B deductible
Long-term care
Largely out-of-pocket — Medicare does not cover custodial care; Medicaid or LTC insurance may help
In Your State
In Florida, Texas, Arizona, Georgia, North Carolina, and South Carolina, some Medicare Advantage plans add in-home support, adult day care, and caregiver benefits for members with dementia. Availability varies by plan and county, and PACE programs exist in some areas.
Tips to Maximize Your Alzheimer's & Dementia Coverage
- 1Use the covered annual cognitive assessment and care-planning visit.
- 2Plan early for long-term care costs — Medicare will not cover custodial memory care.
- 3Compare Medicare Advantage caregiver and in-home support benefits.
- 4Medicaid may help cover long-term care for those who qualify financially.
- 5Look into PACE (Program of All-Inclusive Care for the Elderly) if available locally.
Frequently Asked Questions
Does Medicare cover Alzheimer's care?
Yes for the medical side — diagnosis, doctor visits, cognitive assessments, medications, and some newer treatments. It does not cover long-term custodial or memory care.
Does Medicare cover memory care or assisted living?
No. Medicare does not pay for assisted living room and board or full-time memory care, which are considered custodial care. Medicaid or long-term-care insurance may help.
Does Medicare cover the new Alzheimer’s drugs?
Medicare covers newer anti-amyloid treatments for early Alzheimer’s when the coverage criteria are met, typically under Part B since they are infused.
Does Medicare cover dementia testing?
Yes. Cognitive assessments, care-planning visits, and diagnostic testing — including PET scans when criteria are met — are covered under Part B.
Find a Plan That Covers Your Alzheimer's & Dementia Care
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See all conditions and services Medicare coversThis information is for educational purposes. Consult your doctor for medical advice and a licensed Medicare advisor for plan coverage questions. Plan availability, benefits, and costs vary by ZIP code and change annually; dollar amounts are shown with the year they apply and update each year.
HealthPlan Connect is not affiliated with or endorsed by the federal Medicare program or any government agency. We do not offer every plan available in your area. Last reviewed 2026-06-10 by Lynsey Brennan, Licensed Medicare Advisor (FL License #G007269).