As a geriatric care consultant, I field a lot of questions from people concerned about memory issues in an older loved one. Alzheimer’s Disease is a condition currently affecting over 5 million people in America, and it is estimated that one in three seniors will die with either Alzheimer’s or one of the other forms of dementia. It is the sixth leading cause of death in the U.S. Now comes the cost part. The Alzheimer’s Association estimates that the disease will run up a $213 billion dollar bill this year, and that figure will climb to $1.2 trillion by the year 2050.
So who is going to foot the bill for this frightening condition? Even among those over 65 years of age, Medicare does not come close to covering the entire bill for Alzheimer’s care. The best estimates are that about 60% of the costs associated with the care of an Alzheimer’s patient will be paid by the patient of family of the patient. And the total annual cost for the typical Alzheimer’s patient will come to about $57,000 each year. Here are some costs that you need to watch:
- – Conventional medical insurance or Medicare will not cover adult day care or in-home caregivers. If you as the caregiver have a day job, that can get complicated and costly.
- – Doctor’s visits and most outpatient services are covered, but there will be co-pays. Be careful of which providers may be in-network (and covered) and out of network (not covered)
- – Drugs tend to be covered, with the exception of the “donut hole,” but coverage may be limited to only those medications on a plan’s formulary. Be sure you understand what drugs are covered and prior authorizations are required.
- – Nursing home care is covered up to a point, but this does not include “custodial services.” Medicare will pay for short term nursing home care (up to 100 days), but only following a three day inpatient hospital stay.
- – Make sure you understand what status your loved one is being hospitalized. They may be staying overnight, but it may be labeled “observation” instead of inpatient.
Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric care consultants, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to firstname.lastname@example.org.