Alzheimer's disease and its hefty price tag can be an increasingly scary prospect for seniors and their families.

This incurable condition affects about 5.4 million Americans, making it the nation's sixth leading cause of death.

A recent study by the Alzheimer's Association estimates the annual cost of the disease at nearly $57,000, 60% of which falls on the family's shoulders. Because roughly 90% of Alzheimer's patients are over 65, they and their families rely on Medicare and other insurance to cover costs - which means you it's essential to understand what Medicare does and doesn't pay for:

  • Doctor visits and other outpatient medical services are covered by Medicare Part B. With traditional Medicare, patients pay 20% of the cost of outpatient visits; supplemental insurance, such as Medigap plans, can help cover this extra cost. If you have Medicare Advantage, which usually covers hospitalization, outpatient care and prescription drugs, make sure your doctors are in your insurer's network to avoid excess costs.
  • Drugs are usually included under Medicare Part D. Make sure that insurance covers the drug(s) needed and that you know the co-payment.
  • Medicare will not cover long-term nursing home care (this often comes as an unpleasant surprise to patients and their families).
  • Medicare will pay for up to 100 days of short-term nursing care following a three-day inpatient hospital stay.
  • Medically necessary services provided in your home are sometimes covered, if they're scheduled at least once a week and are provided by skilled healthcare workers (such as nurses or therapists).

Help is available. Check with the State Health Insurance Assistance Program for free and unbiased advice. The Alzheimer's Association, the Medicare Rights Center and the Center for Medicare Advocacy all provide information about this disease and other long-term conditions.

The best defense is to understand your Health insurance benefits and prepare for the future possibility of illness. As always, we're here to help you.

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