Did you know? Medicare now covers Cognitive assessment & care plan services.

When you see your provider for a visit (including your yearly “Wellness” visit), they may perform a cognitive assessment to look for signs of dementia, including Alzheimer’s disease. Signs of cognitive impairment include trouble remembering, learning new things, concentrating, managing finances, or making decisions about your everyday life. Conditions like depression, anxiety, and delirium can also cause confusion, so it’s important to understand why you may be having symptoms.

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Medicare covers a separate visit with your regular doctor or a specialist to do a full review of your cognitive function, establish or confirm a diagnosis like dementia , including Alzheimer’s disease, and develop a care plan. You can bring someone with you, like a spouse, friend, or caregiver, to help provide information and answer questions.

During this visit, your doctor may:

  • Perform an exam, talk with you about your medical history, and review your medications.
  • Create a care plan to help address and manage your symptoms
  • Help you develop or update your advance care plan.
  • Refer you to a specialist, if needed.
  • Help you understand more about community resources, like rehabilitation services, adult day health programs, and support groups.

The Part B deductible and coinsurance apply.

Advance Care Planning

Medicare covers voluntary advance care planning as part of your yearly “Wellness” visit. This is planning for care you would get if you become unable to speak for yourself. You can talk about an advance directive with your health care provider, and they can help you fill out the forms, if you prefer. An advance directive is an important legal document that records your wishes about medical treatment at a future time, if you aren’t able to make decisions about your care.

Consider carefully who you want to speak for you and what directions you want to give. You shouldn’t feel forced to go against your values and preferences, and you have the right to carry out your plans without discrimination based on your age or disability. You can update your advance directive at any time. You pay nothing if it’s provided as part of your yearly “Wellness” visit and your doctor or other qualified health care provider accepts assignment.

Note: Medicare may also cover this service as part of your medical treatment. When advance care planning isn’t part of your “Wellness” visit, the Part B deductible and coinsurance apply.

If you’re in a Medicare Advantage Plan or have other insurance (like Medigap (Medicare Supplement), Medicaid, or employer or union coverage, your copayments, coinsurance or deductibles may be different.

Paying for Long-Term Care

Long-term care (sometimes called “long-term services and supports”) includes non-medical care for people who have a chronic illness or disability. This includes non-skilled personal care assistance, like help with everyday activities, including dressing, bathing and using the bathroom. Non-medical care also includes home-delivered meals, adult day health care, and other services.

Medicare and most health insurance, including Medicare Supplement Insurance (Medigap), don’t pay for this type of care. You may be eligible for this care through Medicaid, or you can choose to buy private long-term care insurance.

You can get long-term care at home, in the community, in an assisted living facility, or in a nursing home. It’s important to start planning for long-term care now to maintain your independence and to make sure you get the care you may need, in the setting you want, now and in the future.

Resources: Medicare & You Book 2022

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