Caring for a loved one with Alzheimer's can be emotionally and financially overwhelming. Many families wonder how they can afford the necessary care, including medical equipment like adjustable hospital beds and mobility aids. Fortunately, Medicaid and Medicare offer crucial support for Alzheimer's care. In this guide, we will explore how these programs work, what they cover, and how you can maximize their benefits to ease your financial burden.
Medicaid and Medicare are two government-funded programs designed to provide healthcare coverage, but they serve different populations and have different eligibility requirements.
Medicaid is a state and federally funded program that provides healthcare coverage for low-income individuals, including seniors and people with disabilities.
Medicare is a federal program that primarily serves individuals aged 65 and older, regardless of income, and younger people with certain disabilities.
|
Feature |
Medicaid |
Medicare |
|
Eligibility |
Low-income individuals |
Age 65+ or certain disabilities |
|
Coverage |
Comprehensive, including long-term care |
Hospital, outpatient, and prescription coverage |
|
Cost |
Low or no cost, depending on the state |
Premiums, deductibles, and copays required |
To qualify for Medicaid, individuals must meet income and asset limits set by their state. Many seniors with Alzheimer's qualify due to high medical expenses and limited financial resources.
Medicaid offers HCBS waivers that help seniors receive care at home rather than in a nursing facility. Services may include:
Personal care assistance
Respite care for family caregivers
Adult day care programs
For individuals who require full-time care, Medicaid covers nursing home stays, including:
Room and board
Skilled nursing services
Therapy services
Medication
Transportation
Individuals 65 and older with Alzheimer's qualify for Medicare. However, Medicare does not cover long-term nursing home care.
Medicare Part A covers:
Hospital stays related to Alzheimer's complications
Limited skilled nursing facility care
Hospice care for end-stage Alzheimer’s patients
Medicare Part B covers:
Doctor visits and cognitive assessments
Physical and occupational therapy
Durable medical equipment (DME)
Medicare Part D helps cover prescription medications, including those commonly prescribed for Alzheimer's patients, such as:
Donepezil (Aricept)
Rivastigmine (Exelon)
Memantine (Namenda)
Some Medicare Advantage plans provide additional benefits, such as:
In-home caregiver support
Meal delivery services
Adult day care programs
Medicare Part B and Medicaid may cover adjustable hospital beds if deemed medically necessary.
Patients with mobility issues may qualify for:
Commonly covered home health products include:
Oxygen therapy supplies
Both Medicaid and Medicare Part D cover essential medications for Alzheimer's treatment.
Includes items such as:
CPAP machines
Orthopedic braces
Visit Medicare.gov or Medicaid.gov
Contact your state’s Medicaid office
Work with a social worker or elder care specialist
If a claim is denied:
Review the denial letter
Contact Medicare or Medicaid for clarification
File an appeal with supporting medical documentation
Medigap and Medicare Advantage plans can help reduce out-of-pocket costs by covering additional expenses.
Wide selection of Medicaid- and Medicare-approved products
Affordable pricing and financing options
Easy online ordering and fast shipping
Visit Shop Home Med to browse their collection of medical supplies eligible for Medicaid and Medicare reimbursement.
Does Medicare cover long-term nursing home care for Alzheimer's patients? No, Medicare does not cover long-term custodial care, but Medicaid may provide coverage for qualified individuals.
Can Medicaid and Medicare be used together? Yes, individuals who qualify for both programs can receive dual benefits to cover various healthcare costs.
Are home modifications covered by Medicaid or Medicare? Medicaid may cover certain home modifications, such as wheelchair ramps, while Medicare generally does not.
How can I get an adjustable hospital bed covered by Medicare? A doctor must prescribe it as medically necessary, and it must be purchased from a Medicare-approved supplier.
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