How to Cover the Cost of Alzheimer's Disease
When you or someone close to you is diagnosed with Alzheimer’s disease, there are many things to consider and plan for. One of them is the cost of care. When you understand the expenses and plan for what’s ahead, you and your family can be better prepared for the financial impact of the disease. Though insurance may cover some costs, the price can go up sharply as the illness progresses; health insurance typically pays only for certain medical treatment, not the caregiving that Alzheimer’s patients will need. Here are some steps you can take to prepare for the expenditures that come with an Alzheimer’s diagnosis.
Check your policy carefully and contact the insurance provider if you don’t understand your coverage. If the patient has Medicare Part B, that will cover evaluation, diagnosis and doctor’s services, but it does not pay for prescription drugs, many home services, day care, or long-term care costs. The supplemental health insurance plans you can buy when you are 65 and older, known as Medigap plans, can help with coinsurance and other expenses—but the plans vary. If you’re enrolled in Medicare Part D, the government provides coverage for some drug costs, which you can further supplement by purchasing an additional private prescription drug plan. Choose carefully—you may want to work with an insurance agent or benefits advisor who specializes in Medicare. The coverage is complicated, so make sure you understand it.
If the patient is younger than 65, private health insurance may cover the cost of Alzheimer’s medicine, but again, it depends on the policy. Private insurers may limit access to some drugs or require that specific drugs first be prescribed. You can apply for disability programs through the government, including Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), which may provide income to qualified individuals with early-onset Alzheimer’s. Long-term care insurance, which you buy privately, can cover many nursing and living expenses, but be aware that benefits vary widely depending on the plan, and you cannot buy it after the diagnosis has been made.
The costs of care vary in different areas of the country, so do your research locally. Many county and local governments offer various kinds of assistance and information, as does the federal government. Try the U.S. government’s Eldercare Locator website or look at the Alzheimer’s Association, which can help you locate nearby services through their Community Resource Finder.
As the symptoms of Alzheimer’s progress, you may find you need outside help to care for the person in the home. Think about how many hours a week you may need help, what it might cost, and how that cost might increase as time goes on.
Be aware of safety-related expenses that can come up. You may need modifications to the home, such as alarms or cameras to prevent wandering.
Many Alzheimer’s patients will attend an adult day care facility at some point, which specializes in patients with memory loss and other symptoms of dementia. Again, costs vary, but some offer fees based on a sliding scale according to need and ability to pay. Medicaid may pay for the daily care of those with few or no financial assets.
Often, people with Alzheimer’s eventually need to move into an assisted living facility or nursing home. Some facilities will accept Medicaid, but Medicare does not cover these costs—and that’s where the sticker shock can really hit. The average national cost for basic services in an assisted living facility is more than $40,000 per year. A semi-private room in a nursing home will be close to $80,000 a year, and a private room can reach almost $90,000 annually. Other coexisting medical conditions can greatly increase the cost of patient care.
Take a look at the financial assets that will be available. This includes long-term care insurance, savings and retirement accounts, pensions, annuities, and assets like real estate. Review possible assistance programs such as veterans benefits and SSI. Alzheimer’s planning specialists, also called Alzheimer’s financial planners, make a living advising families who are facing financial challenges and decisions that come with the disease. You may want to contact one to help you, but make sure that he or she has the proper credentials and qualifications. Look for a certified financial planner (CFP) and ask if he or she has experience with elder care or long-term planning.
Before Alzheimer’s makes it difficult for a patient to remember where important documents are kept, gather the information you will need about bank accounts, savings and investment accounts, deeds, wills, insurance and other important papers. Understand the monthly bills and other living expenses that need to be paid. This could be a good time to have a conversation about who will have power of attorney if that becomes necessary and who will be the primary person responsible for handling finances and financial decisions.
Alzheimer’s disease presents many challenges over the years, but getting a firm handle on insurance coverage, future expenses and available assets will help you focus more of your time on providing the emotional and psychological support that Alzheimer’s patients–and their caregivers–need.
Remember, many families have already taken this journey and have much wisdom to share. Practical solutions abound for many of these challenges. Do not hesitate to reach out to your health care team, social workers, community agencies, and nonprofit support groups for expert guidance.