Can Medicare help cover in-home care for dementia patients who wander or need supervision 24/7?

Question

Lt Col Tim Brown · Accepted Answer

Home health care initiated by your doctor is covered.  Long term care is not covered by medicare.  So it will depend on what definition it is listed as.  Consult your doctor on which it could be.

Steven Graves · Answer

Medicare generally does not cover long-term in-home care or 24/7 supervision for dementia patients, including those who wander or need constant monitoring. Here’s a quick overview:

What Medicare Covers:
Skilled nursing care at home: Short-term care prescribed by a doctor, like skilled nursing visits or therapy after hospitalization

Home health aide services: Assistance with medical tasks, but only if part-time and medically necessary

Durable medical equipment: Items like hospital beds or safety alarms that might help with wandering

What Medicare Doesn’t Cover:
Non-skilled custodial care: Help with daily activities like bathing, dressing, supervision, or wandering prevention is typically not covered

24/7 supervision or round-the-clock care

Alternatives to Explore:
Medicaid: Often covers long-term care services, including in-home custodial care, but eligibility depends on income and assets

Long-term care insurance: Some policies cover in-home care and supervision

Community resources: Adult day care, respite care, and support programs for dementia patients and caregivers

If you want, I can help you explore local resources or insurance options that might provide the care and supervision needed for your loved one. Would that be helpful?   Contact us.

Michael Denniston · Answer

Medicare itself does not usually cover patients who wander or need supervision 24/7. If this becomes the case, I recommend LTC insurance. Long Term Care insurance can provide coverage for this. For more details call or email today.

Answered by Michael Denniston on June 2, 2025

Agent Licensed in FL, AL, AR & 11 other states

Answered by Michael Denniston Medicare Insurance Agent

Mary Turner · Answer

Having gone through helping take care of my stepfather who had dementia, I know what a daunting task it can be.  He was an outstanding man who never raised his voice and treated my sister and I as if we were his very own.  Dementia turned him into someone I barely recognized at times.

Unfortunately, whether you have medicare and a supplement or a medicare advantage plan, neither will help because medicare does not pay for long term care whether it be in home or in a facility.  My sister and I took turns staying with my stepfather "dad" and employed caretakers for the other days and nights since he required 24/7 care.

If the person already has dementia there is little you can do other than pay out of pocket until medicaid qualified.  If this is a hypothetical situation, there are several ways you can protect yourself for long term care.

Theodore Carpenter · Answer

No, Original Medicare does not provide in-home care for dementia patients who wander or need 24/7. This is why buying long-term care is necessary to protect yourself from such situations.

Angie Templin · Answer

While Medicare does not cover nursing homes, memory care centers, or in home caregivers, there can be coverage through Part A under hospice benefits. Because Alzheimer's Disease is a terminal condition, Medicare will cover hospice care in advanced stages.

Answered by Angie Templin on May 5, 2025

Broker Licensed in TX

Answered by Angie Templin Medicare Insurance Agent

Katheryn Evans · Answer

Medicare does not cover Long Term Care. 24/7 Supervision of a dementia patient is Long Term Care. There are strategies that can be employed. It is a good idea to talk to a broker about options available.

Answered by Katheryn Evans on May 20, 2025

Agent Licensed in WA, AZ, CA & 13 other states

Answered by Katheryn Evans Medicare Insurance Agent

Fred Manas · Answer

Medicare generally doesn't cover 24/7 in-home care for dementia patients who wander or need constant supervision, but it can cover part-time, intermittent care for those who are "homebound" and need skilled nursing or therapy. This means Medicare Part A may cover up to 35 hours per week of home health services, but not 24-hour-a-day care.

Answered by Fred Manas on May 4, 2025

Agent Licensed in NY, CT, DC & 7 other states

Answered by Fred Manas Medicare Insurance Agent

Vachik Chakhbazian · Answer

Medicare generally doesn't cover 24/7 in-home care for dementia patients who wander or need constant supervision, but it can cover part-time, intermittent care for those who are "homebound" and need skilled nursing or therapy. Medicare may cover home health services, including skilled nursing, physical therapy, and speech therapy, if a doctor deems these services medically necessary and the person is "homebound". However, Medicare doesn't cover personal care like bathing or dressing, or homemaker services like laundry and shopping

Answered by Vachik Chakhbazian on May 29, 2025

Agent Licensed in CA, AL, AR & 22 other states

Answered by Vachik Chakhbazian Medicare Insurance Agent

Gary Henderson · Answer

Medicare supplement plans provide in-home treatment for medically necessary needs 
They do not act as babysitters if you will 
They will come into your home to administer medication as needed and other medical Care 
They do not do housekeeping or any other type of domestic work 
If you have Medicare advantage plan, then you have to make sure that the home Care company will take your plan. That's why Medicare supplement plans are always better because if the home care company takes Medicare, they will automatically take your plan

Mike Henry · Answer

No Medicare doesn’t nor never has coverage for this. You need to get a long term care policy. Only thing that will cover that

Todd Bostic · Answer

Typically unless it’s part of a skilled nursing or hospice care plan, it doesn’t cover 24/7 of the cost for in-home care for dementia patients who wander or need supervision.

Donnie Vermillion · Answer

Medicare does not cover around the clock supervision or personal care. Long Term Care insurance helps with ADL's "activities of daily living" and dementia specific needs. Depending on the policy it may help cover personal home care.

Answered by Donnie Vermillion on May 6, 2025

Broker Licensed in TX

Answered by Donnie Vermillion Medicare Insurance Agent

Dominic Javier · Answer

Yes, through the cognitive assessment and care plan services that will look for signs of dementia, including Alzheimer's disease. Signs of cognitive impairment include trouble remembering, learning new things, concentrating, managing finances, or making decisions about your everyday life. Your doctor should check on you and give you are care plan, including supervision 24/7 if indeed needed.

Answered by Dominic Javier on May 5, 2025

Broker Licensed in TX

Answered by Dominic Javier Medicare Insurance Agent

Curtis Stoner · Answer

Medicare does not generally cover 24/7 in-home custodial care for dementia patients, even if they wander or need constant supervision.

Jody Hill · Answer

Medicare will covered skilled care but not custodial care. It does not have coverage for someone to do household chores and babysitting services. They would have to look at other ways that may cover more like Medicaid.

Answered by Jody Hill on August 8, 2025

Agent Licensed in FL

Answered by Jody Hill Medicare Insurance Agent

Carl-Daniel Cole · Answer

Medicare may cover limited in-home care for dementia patients, but only if skilled nursing or therapy is medically necessary. It does not cover 24/7 supervision or custodial care, such as help with wandering or personal care. Long-term care services like that are typically not covered.

Answered by Carl-Daniel Cole on May 20, 2025

Broker Licensed in MO, AL, AR & 23 other states

Answered by Carl-Daniel Cole Medicare Insurance Agent

Angelique Solomon · Answer

Medicare covers in-home care for dementia only if skilled services are needed (like nursing). It doesn’t cover 24/7 supervision or help with wandering.

Rhonda Byers · Answer

Medicare does not usually cover this home health care. This would fall under long term care. Medicare is health insurance and not convulsant care.

Doris Bejarano · Answer

Dear, 
Unfortunately Medicare does not cover LTC, one way will be applying to Medicai in your state and see if you qualify. 
Other it could be using an annuity with a LTC rider. 
Every case is unique.

April Gruber · Answer

That's a great question. In short, the answer unfortunately is no, but there are other resources that might be available for your loved one.

Medicare will cover medically necessary home health care (short-term, intermittent skilled care), but there are some key requirements:
- A physician must attest that the patient is homebound and needs skilled nursing or therapy
- Care is part-time or 'intermittent' (generally 8 hours or less daily, up to 7 days per week, for 21 days or less)
- Services are provided by a Medicare-certified home health agency
Medicare does NOT cover:
- 24/7 in-home care
- Personal or custodial care (help with bathing, dressing, supervision, or companionship) unless it's part of the skilled care plan

Often times, families find themselves patching together multiple resources to help meet their loved one's care needs. Think of it as a patchwork quilt. Government programs are usually the best place to start. Medicaid (state-based health insurance), unlike Medicare, does cover long-term custodial care. But exactly what is covered can vary from state to state. Many states offer Home and Community Based Services (HCBS) Waivers that help individuals with dementia gain access to care at home instead of an institution. Keeping your loved one in a familiar environment as long as possible. Eligibility for Medicaid is based on income and assets, and because those amounts vary by state it is important to get with your local Medicaid office for those details and to apply for their services. For those who are eligible for Veterans' Benefits, VA Aid and Attendance Pension can help pay for in-home care, assisted living, or nursing home care. 
For those who plan ahead, a Long-Term Care policy can help cover costs for in-home caregivers, assisted living, or nursing home. Policy costs and details vary from plan to plan, and should be purchased earlier in life. It is always wise to work with an experienced broker who is familiar with local resources.

Can Medicare help cover in-home care for dementia patients who wander or need supervision 24/7?

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Can Medicare help cover in-home care for dementia patients who wander or need supervision 24/7?

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