Alzheimer’s disease can turn life upside-down for both the person diagnosed and the people who care about them. Along with the emotional impact, there are also important decisions to make about care, treatment, and how to pay for it. Medicare can play a key role in covering some of these costs, but the rules can be complex. Understanding how Medicare works with Alzheimer’s can help you plan smart and feel more prepared for the road ahead.

What is Alzheimer’s disease?

Alzheimer’s disease is a progressive and irreversible brain disorder and a form of dementia. It can make people lose their memory, act differently, and have trouble thinking and solving problems. Risk for this disease increases after age 65.

According to the Alzheimer's Association, more than 7 million people in the United States have Alzheimer’s. These patients also may suffer from depression, agitation, anxiety, and other health conditions.

What does Medicare cover for Alzheimer’s disease?

If you have Alzheimer’s disease, Medicare will cover your care for related medical and mental health conditions. Below is an overview of how Medicare covers this disease.

Ongoing hospital care, doctor visits and needed medical items

This includes care for diagnosis and treatment:

• Diagnosis: Medicare will help pay for the doctor visit, physical exam and several tests used to diagnose Alzheimer’s disease. Medicare will only cover the costs of PET (Positron Emission Tomography) scans in certain cases for Alzheimer’s. PET scanning is a medical test that can diagnose Alzheimer’s disease in its early stages.
• Treatment: Medicare also helps pay when you see your doctor to treat and manage Alzheimer’s disease. It will pay if your doctor asks another doctor to see you. Medicare also will pay if your doctor oversees your home health or hospice care.

Mental health services

Sometimes, people with Alzheimer’s need mental health services, too. Medicare provides mental health benefit that covers sessions psychiatrists, clinical psychologists, or social workers. Medicare will cover 80% of the amount it approves for an outpatient mental health service. It also fully covers a yearly depression screening as long as the provider accepts Medicare. Learn more about mental health coverage.

Medical social services

A social worker can visit you at home to counsel you and help you deal with the social and emotional side of Alzheimer’s disease. Your doctor must order these services.

Care planning

Medicare covers care planning services for people who have been newly diagnosed with cognitive impairment, including Alzheimer’s disease and other dementias. These services help patients and their caregivers understand available medical and non-medical treatments, explore clinical trials, and connect with community-based support. The goal is to improve the person’s quality of life while providing critical support for caregivers and family members.

Medical supplies

Your doctor may include orders for certain medical equipment and supplies if you need this equipment to live at home. This includes a walker, wheelchair or oxygen equipment.

Prescription drugs

All Medicare Part D plans must cover at least two drugs used to treat Alzheimer's symptoms. These medications typically:

• Raise the levels of brain chemicals to aid memory and judgment, called cholinesterase inhibitors
• Help improve memory, attention, reason and language, called memantine

Part D plans must also cover "all or substantially all" antidepressants, antipsychotics, and anticonvulsants that many Medicare beneficiaries with Alzheimer's require.

Alzheimer's medications and Medicare 

A drug for Alzheimer’s called Leqembi® (generic name lecanemab) was granted traditional approval by the U.S. Food and Drug Administration in 2023. It works by targeting and removing a protein in the brain called amyloid beta—a key contributor to Alzheimer's disease. Lequembi® is one of two anti-amyloid Alzheimer's disease treatments on the market (Aduhelm was a third, but it was discontinued in 2024). Lequembi® was also the first anti-amyloid Alzheimer's treatment to qualify for broader coverage under original Medicare.

In 2024, Kisunla™ (donanemab)—another anti-amyloid treatment—also received full approval from the FDA to treat early-stage Alzheimer's disease. This includes people with mild cognitive impairment or mild dementia caused by Alzheimer's (as long as they have confirmed elevated levels of beta-amyloid in the brain).

Like Leqembi, Kisunla is covered by Medicare as long as clinicians participate and enter data into a centralized CMS registry. These drugs are not approved for treating more advanced stages of the disease or for patients who have no symptoms.

Medicare does not cover these types of care for Alzheimer’s disease:

• Long-term care: This includes long-term nursing home stays beyond 100 days, the costs of assisted living facilities, and adult day centers.
• Personal care, also called custodial care: This includes paying another person to help you bathe, dress, fix meals, and do other daily activities. People with Alzheimer’s disease often need more and more custodial services as time goes on.

Medicare will cover custodial care, both at home and during a brief stay in a skilled nursing facility, but only when you also need and get skilled care. People with Alzheimer’s disease often need other types of care that Medicare does not cover. Alzheimer’s patients and their families often must pay for these services out of pocket if they do not qualify for Medicaid or long-term care insurance.

Visit NCOA’s Alzheimer's & Dementia resource library to learn more.