Does Medicare pay for memory care? What to expect

Dementia care looks different for every family, but one question comes up again and again: Will Medicare help cover the cost?

Whether care happens at home or in a memory care community, supporting someone with Alzheimer’s or another form of dementia often requires full-time supervision, daily assistance and a safe, structured environment. Some families provide that care themselves, others turn to specialized facilities, and many use a combination of both.

“One of the most common misconceptions we encounter is the belief that Medicare covers this care,” says Rachel Reeves,  spokesperson for the American Health Care Association/National Center for Assisted Living (AHCA/NCAL). “This confusion leaves families often unprepared for the financial realities of memory care.”  

More than 6.9 million U.S. adults over age 65 are living with dementia, and the Alzheimer’s Association projects that number will nearly double by 2060. As the need for care grows, so does the cost and the importance of understanding how Medicare fits into the picture — and where it falls short. This piece explains what memory care includes, what Medicare may or may not cover and how to explore other options for financial support.

What is memory care — and who is it for?

Memory care is a specialized type of long-term care for individuals with Alzheimer’s disease or other forms of dementia. It’s designed for people who can no longer live safely at home due to memory loss, behavioral changes or an increasing need for supervision.

Whether you are planning ahead or facing decisions right now, understanding what to expect can make a difficult process more manageable.

In many cases, Reeves says families will turn to memory care in a long term care facility when the individual’s safety becomes a concern (i.e., increased wandering, confusion or difficulty managing medications). “Sometimes, seniors and their families seek out memory care earlier in the disease process, especially in assisted living,” she explains. “But unfortunately, it is common for families to wait for a crisis event, such as a fall or hospitalization, before seeking professional care.”

Types of memory care settings:

• A person’s home, supported by professional caregivers or trained family members.
• A dedicated memory care unit within an assisted living facility.
• A standalone memory care community.
• A skilled nursing facility with a dementia care wing.

Some states have legislation requiring nursing homes and assisted living residences to disclose their fees and list the specialized services their memory care unit provides, including a trained staff, specialized activities and ability of staff to care for residents with behavioral needs. 

Memory care is one of the most expensive forms of long-term care, with monthly costs averaging $6,935 nationally.

Memory care services may include:

• 24/7 supervision to prevent wandering or injury.
• Assistance with activities of daily living (ADLs) like dressing, bathing and eating.
• Medication management.
• Structured, therapeutic activities.
• Secure, calming environments.

“During the middle stages of Alzheimer’s, it becomes necessary to provide 24-hour supervision to keep the person with dementia safe,” says Elizabeth Edgerly, senior director of community programs and services at the Alzheimer’s Association. “As the disease progresses into the late stages, around-the-clock care requirements become more intensive.”

Because laws vary, it is important to ask specific questions about what type of care is provided to ensure that the level of care is appropriate for your loved one. 

The cost of memory care

Memory care is one of the most expensive forms of long-term care, with monthly costs averaging $6,935 nationally and ranging from $6,100 to $8,000 depending on location and services, according to the 2024 Cost of Care Survey conducted by Genworth and CareScout. The higher cost, often 20% to 30% more than standard assisted living, is due to factors like increased staffing, dementia-specific training, secure environments and specialized programming.

“The cost of long-term care can be eye-opening for families,” says Edgerly. Case in point: Results from a 2024 poll from the University of Michigan showed 62% of adults age 50 and older mistakenly believe Medicare will cover long-term care, such as living in assisted living or memory care settings, which it does not.

Read more:

How much does memory care cost? 

Does Medicare pay for memory care at home?

Many people in the early stages of dementia benefit from staying at home, but caregiving is complex, time-consuming and often exhausting. While Medicare doesn’t cover long-term custodial care, it may provide some support to help people remain safely at home for as long as possible.

Medicare may cover:

• Up to 35 hours per week of home health care (with a doctor’s order) for people who are homebound and need skilled nursing or therapy.
• Cognitive assessments and dementia care planning visits with a provider (Part B).
• Prescription medications for dementia-related conditions (Part D).
• Hospice services for those with a life expectancy of six months or less who are no longer seeking curative treatment.

It will not cover: 

• Around-the-clock care or daily supervision.
• Help with bathing, dressing, cooking or other personal care.
• Adult day centers or non-medical respite services.

Medicaid may help fill in some of these gaps through Home and Community-Based Services (HCBS) waivers, which can fund in-home aides, personal care, and adult day programs aimed at preventing or delaying nursing home placement.

To support family caregivers, some states also offer self-directed Medicaid programs that allow families to pay trained relatives (and, in some states, spouses) using Medicaid funds. Examples include:

• California – In-Home Supportive Services (IHSS).
• New York – Consumer Directed Personal Assistance Program (CDPAP).
• Pennsylvania – Community HealthChoices.

Eligibility varies, and not all states offer this option. Contact your state’s Medicaid office to learn more.

Does Medicare pay for memory care facilities?

If your loved one transitions to a memory care community, Medicare coverage becomes more limited. While it continues to support medical needs, it won’t cover the housing, meals or personal care that make up the bulk of memory care costs.

Medicare will cover:

• Inpatient hospital care for illnesses or injuries.
• Cognitive assessments and care planning visits.
• Dementia-related medications (via Part D).
• Short-term skilled nursing care after a hospital stay (up to 100 days, if eligible).
• Hospice services for qualifying individuals.

Medicare won’t cover:

• Room and board in memory care facilities.
• Ongoing personal care, like help with bathing or dressing.
• Non-medical, 24/7 supervision.

A new Medicare pilot for dementia care

In July 2024, Medicare launched a pilot program called the GUIDE Model (Guiding an Improved Dementia Experience). The program is endorsed by the National Council of Certified Dementia Practitioners (NCCDP) and provides:

• A care navigator.
• 24/7 access to dementia-specific support.
• Caregiver training.
• Respite services aimed at keeping people with dementia safely at home longer.

“We’re advocating for the GUIDE Model’s permanent integration into Medicare, along with broader support for Medicaid Home and Community-Based Services (HCBS) that fund in-home care and caregiver support,” says NCCDP Director of Operations, Jason Stutz. “We’re also calling for national standards in dementia training across all care settings.” These reforms, he adds,  are essential to meeting the complex needs of individuals living with dementia and ensuring equitable, dignified care.

The program is expected to run through 2032 and is available to traditional Medicare beneficiaries with a dementia diagnosis who live at home or in non-nursing settings. However, its continuation under the Trump Administration is uncertain. CMS did not respond to Care.com’s request for comment on the GUIDE Model program status. 

Why memory care costs more than standard assisted living

Memory care typically costs more than standard assisted living — and for good reason.

“Memory care requires round-the-clock support tailored to the unique needs of individuals with dementia,” says Denise Scruggs, NCCDP Director of Education. “That includes everything from enhanced safety to personalized therapeutic programs.”

According to Scruggs, key cost drivers include:

• Higher staffing ratios, often 1:6 compared to 1:15 in traditional assisted living.
• Specialized staff training in dementia care and behavior management.
• Personal care support, including help with daily activities and medication.
• Enhanced safety measures, such as secured environments, alarms and GPS tracking.
• Therapeutic activities, like music, art or sensory therapy designed to support memory.
• Purpose-built environments designed to support memory and reduce confusion.
• Increased liability insurance and operational costs.

This level of supervision and structure is critical for safety and well-being, but it isn’t reimbursed by Medicare. This leaves families looking for other ways to cover the costs. 

Other ways to pay for memory care

Because Medicare doesn’t cover long-term memory care, families often rely on a patchwork of funding sources. Each option comes with its own eligibility rules, coverage limits and trade-offs, so it’s important to plan ahead and seek guidance if needed.

• Medicaid: May cover memory care services (but not room and board) through state-specific Home and Community-Based Services (HCBS) waivers. Coverage and eligibility vary widely by state, and waiting lists are common. According to a 2024 survey from the Kaiser Family Foundation, over 710,000 people are currently waiting for Medicaid HCBS services. 
• Long-term care insurance: May cover in-home or facility-based care, depending on the policy. According to LIMRA, an insurance industry research group, fewer than 1 in 25 adults over age 50 have such insurance.
• Veterans benefits: The U.S. Department of Veterans Affairs may provide financial assistance through programs like Aid and Attendance or Community Residential Care for qualifying veterans and surviving spouses.
• Private savings and assets: Many families use retirement accounts, pensions, life insurance conversions or reverse mortgages.
• Local and nonprofit assistance: Some state or community programs, religious organizations and nonprofits offer grants, respite care funding or financial counseling for dementia care. Your local Area Agency on Aging can be a helpful resource.

Christopher Mini, a Floridian whose late mother lived in a memory care facility, says his family paid $6,100 a month for the smallest room and board — plus more money on supplies, clothing, dietary supplements and medical expenses. “We cobbled together the money each month from a pension passed from my dad to my mom upon his passing, a social security survivor benefit and their life savings,” Mini says. “Without that pension – which provided more than half of the monthly need – I have no idea how we would have handled care for my mom.” 

With projections showing a dramatic increase in the need for memory care facilities over the next few decades, Mini’s story highlights the need for funding reform. Channa Kelly, a long-term care consultant in California, urges policymakers to do more: “We need more resources allocated to expand long-term care capacity and robust programs to provide respite care and financial assistance for families managing at-home dementia care.” 

By prioritizing these efforts today, Kelly says we can shape a future where every individual with dementia receives the care and support they need. 

A final memory care tip: Plan ahead

Medicare does not cover long-term memory care, including room and board in a facility or daily support with personal care. It may provide some support at home or during short-term medical events, but most families must rely on Medicaid, long-term care insurance, veterans’ benefits, or private savings.

Understanding these limits early can help families plan ahead and avoid crisis decision-making when care needs increase. As Mini says: “Rarely does anybody freely talk about the financial realities of long-term care; now more than ever, it’s crucial to plan ahead.”