Dementia, Alzheimer’s & Long-Term Care Costs:
- A dementia or Alzheimer’s diagnosis often raises a bigger question than “what does Medicare cover?”
- The real issue is usually:
- who pays when someone needs supervision, home care, assisted living, or nursing care?
- Quick reality check:
- Medicare may help with doctors, hospital care, prescriptions, and limited skilled care —
but it generally does not pay for long-term custodial care. - That is where Medi-Cal, IHSS, long-term care planning, and family support come in.
- What is Dementia Video?
- Understanding Causes, Symptoms, Diagnosis and Treatment Video National Institute of Aging
- nia.nih.gov/ what-dementia-symptoms-types-and-diagnosis
- Medicare may help with doctors, hospital care, prescriptions, and limited skilled care —
What Is Dementia Care? (And Why It Gets Expensive)
Dementia care is not just medical treatment. It usually involves ongoing supervision, safety support, memory assistance, and help with daily living such as eating, bathing, dressing, and medications.
Typical levels of dementia care:
- Family care – help from spouse or relatives
- In-home care (IHSS or private) –
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- caregiver support at home
- Do you need to lower your share of cost?
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- Adult day care – structured daytime supervision
- Assisted living / memory care – residential supervision
- Skilled nursing facility – 24-hour medical & custodial care
The key point is that most of this is custodial care, not medical care. That’s why Medicare coverage is limited —
and why planning ahead can make a big financial difference.
👉 Most families don’t realize the biggest cost is not medical care — it’s supervision and long-term support.
| Long-Term Care Options | Get Help at Home (IHSS) |
Nursing Homes & 24-Hour Care |
What Medicare Covers — and What It Does NOT Cover
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✔ What Medicare DOES Cover
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✖ What Medicare Does NOT Cover
|
👉 This is where most families get surprised. Medicare covers medical care —
but dementia often becomes a long-term care and supervision issue.
That’s why people often end up looking at Medi-Cal, IHSS (home care support), long-term care planning, or family caregiving options.
When Medicare Stops, Medi-Cal Planning May Matter
If dementia care becomes long-term custodial care, Medicare may not be the main payer.
Families often have to look at whether the person may qualify for Medi-Cal, IHSS, nursing home Medi-Cal, or Medi-Cal with a Share of Cost.
Important planning point: Some people are told they have too much monthly income for free Medi-Cal and are assigned a
Medi-Cal Share of Cost. In some cases, recurring health insurance premiums may help reduce or eliminate that Share of Cost.
This does not mean every person with dementia will qualify. But it does mean families should ask the right question early:
Is this a Medicare issue, a Medi-Cal issue, an IHSS issue, or a long-term care planning issue?
| Medicare Medical care, doctors, hospital, prescriptions, limited skilled care. |
Medi-Cal / IHSS Possible help with home care, nursing facility care, and long-term support if eligible. |
Share of Cost A monthly amount some people must meet before Medi-Cal pays. |
👉 The wrong assumption can cost a family thousands of dollars.
Don’t assume Medicare, Medi-Cal, or a nursing home will automatically handle everything.
IHSS Home Care Help |
Nursing Home Medi-Cal |
Reduce Share of Cost |
- Links & Resources
- Durable Medical Equipment, Chiropractic, Physical Therapy
- Hospice Coverage – Medicare
- Skilled Nursing SNF & Home Health What Medicare Pays
- Medicare & Medi Cal coverage for people with Dementia CMS Publication
- Long Term Care Nursing & Home Health Care
- Cognitive assessment & care plan services Medicare.Gov
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#Understanding Medi-Cal Long Term Care pdf CHCF
Archive Rev 2001- CANHR California Advocates for Nursing Home Reform
- Our Webpage on Redetermination Requalification
- Our webpage on how to qualify for Medi Cal Nursing Home Benefits
- When will California’s Medi-Cal Will Pay for a Nursing Home, Assisted Living, or Home Care Nolo.com
- Long-Term Services and Supports in Medi-Cal Fact Sheet CHCF.org
- canhr.org/overview-of-medi-cal-for-long-term-care
Understanding Long-Term Care Medi-Cal Peservation National Law.com
#Power of Attorney
Bibliography, Resources & Links
- jaci law.com/power-attorney-vs-conservatorship
- Get Standard – Statutory Forms
