Special Needs Plan for Alzheimer’s

Jun 3, 2021 | Medicare Advantage

Battling Alzheimer’s disease can be costly and may require specialized care, but a Medicare Advantage Special Needs Plan can help provide additional coverage in treating and managing Alzheimer’s.


The cost of Alzheimer’s

In 2020, the total cost for Alzheimer’s care in the United States was $305 billion. The amount could increase up to $1.1 trillion by 2050 (in 2021 dollars).1

The total average annual cost per person in 2019 was $50,201 from different payment sources. From this number, $25,213 was from Medicare.

Since Alzheimer’s is a progressive disease, the costs to care for someone with Alzheimer’s may change over time. While insurances such as Medicare may cover some of the costs, it is a good idea to prepare for other amounts that insurances may not cover in full.


Alzheimer’s care

Some of the most common costs to care for someone with Alzheimer’s are:

  • Medical treatments for symptoms, diagnosis, regular doctor’s visits
  • Treatment for other medical conditions
  • Safety and security for a person who wanders
  • Prescription drugs
  • Personal care
  • Adult daycare services
  • In-home caregiving services (full-time or part-time)

Those who are in the latter stages of Alzheimer’s may opt for a long-term care service such as joining an assisted living facility, a nursing home, or getting full-time home care.


Medicare Advantage Special Needs Plan (SNP) for Alzheimer’s

Medicare beneficiaries who have Alzheimer’s may opt to get a Special Needs Plan (SNP) to get additional coverage to help with treating and managing Alzheimer’s. A Special Needs Plan provides benefits that best meet the needs of someone with Alzheimer’s.

There are specific requirements to be met to enroll in an SNP plan. Alzheimer’s disease, being a type of dementia, is considered part of the Chronic Condition SNP (C-SNP) eligibility requirements.


How can I join an SNP?

To enroll in a Medicare SNP, you must:

  • Have Medicare Part A and Part B
  • Live in the plan’s service area
  • Have any of these conditions:
    • A chronic condition such as dementia (see the full list from Medicare.gov
    • You live in an institution like a nursing home or require nursing care at home
    • You have both Medicare and Medicaid


Can I go to any doctor or health care provider while enrolled in an SNP?

You must get care from doctors or providers within the Medicare SNP network. You may still use out-of-network care for emergency situations. If you have an End-Stage Renal Disease, you can also opt for out-of-area dialysis.

If you have any questions about Special Needs Plan, contact me so I can help you make an informed decision and get a plan that suits your needs.

Learn more about Medicare Advantage


References:

1 Alzheimer’s Association. (n.d.). Alzheimer’s and Dementia.https://www.alz.org/alzheimers-dementia/facts-figures

2 Medicare.gov. (n.d.). Special Needs Plans (SNP). https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/special-needs-plans-snp

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