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Medicare Covered Dementia Support Services

The GUIDE Model (Guiding an Improved Dementia Experience) provides care navigation and funding to care for those with a dementia diagnosis. Let us help you apply today!

Dementia Care Management, Covered Support Services and In-Home Respite Care 

If your loved one has dementia or Alzheimer’s, you are not alone. Medicare is now now offering a voluntary program called GUIDE. It provides comprehensive support to eligible Medicare beneficiaries and their caregivers at no out-of-pocket cost.

The program's goal is to help people with dementia remain safely in their homes for longer through funded respite care and care navigation support for family caregivers. 

Successful caregiving means having the right support team, taking breaks and accepting short-term relief through respite care that can be paid for through GUIDE.

Family members caring for a loved one with dementia shouldn’t do it alone.

Caregiving is a public health concern because it can lead to significant physical, emotional, and psychological strain. Nearly 1 in 5 caregivers report fair or poor health, and almost 2 in 5 caregivers are living with at least two chronic conditions themselves. Caregivers often neglect their own health needs, which can worsen these challenges and put them at greater risk for long-term health problems¹. Contact a participating office to see if you and your loved ones qualify for GUIDE or to learn about home care benefits. Get the support you need to avoid becoming a statistic. 

What is GUIDE?

GUIDE is a no out-of-pocket Medicare Part B program that provides comprehensive and coordinated care for individuals living with dementia and provides added support for their family caregivers. The goals of GUIDE are to:

  • Improve the quality of life for people living with dementia
  • Enhance support for caregivers of people living with dementia  
  • Help people living with dementia stay in their homes and communities longer

Services included

GUIDE is available to traditional Medicare beneficiaries (Part A & B primary) with a dementia diagnosis who do not reside in a nursing home, retirement care community (RCC), assisted living, assisted living with memory care or are enrolled in hospice or PACE. If the individual lives in their residence or independent living, they can apply. 

Not sure what type of Medicare you have? No problem - we’ll be able to identify if insurance qualifications can be met within a timely fashion and if so, we’ll walk you through the program process and benefits.  Note: you will not be billed by Medicare. This is a no out-of-pocket program for eligible Medicare beneficiaries with no copays or any financial responsibilities. Medicare covers all expenses related to this program.

If approved, GUIDE beneficiaries and their unpaid, family caregivers will receive access to nine care delivery services including:

  • Care navigation
  • Comprehensive assessment & care plan development
  • Dementia diagnosis - you do not need a formal diagnosis to apply 
  • Caregiver support & education
  • Respite services (for those with moderate to severe dementia)
  • 24/7 access to a care team or helpline  
  • Ongoing monitoring & support 
  • Access to resources, education and counseling 
  • Medication management support

The GUIDE Model is more than just respite services. It is a connected benefit that supports the entire family because it is just as important that the family caregiver is supported, as is the individual living with dementia.

This approach helps people with dementia remain safely in their homes longer, potentially delaying or preventing the need for nursing home placement. It also seeks to enhance the quality of life for both individuals with dementia and their unpaid caregivers.   

 

GUIDE in-home respite care

Caregiving comes with a multitude of demands that can be alleviated with respite care. If approved for GUIDE and its respite benefit, you can expect:

  • Care provided in four-hour increments.
  • Coordinated services between you and ComForCare. We will work together to develop a schedule that works for you and your loved one.
  • Respite care day or night.
  • Care by dementia-trained caregivers through DementiaWise®.
  • Services to include showering, dressing, laundry, meal prep, medication reminders and companionship.
  • To take a break while we care for your loved one.

 

How it works. Get started today by following these steps:

  1. Contact your local ComForCare office, an approved organization and respite partner, who will begin the process. ComForCare works with multiple GUIDE Partner Organizations which makes it possible for ComForCare, an approved organization, to bring this valuable program to our communities. 
  2. The family and person with dementia will meet with our Partner Organization, who will provide an educational session, insurance review and will enroll you into GUIDE.
  3. Next, the family and individual with dementia is assigned a Care Navigator who will complete the care delivery services as part of the GUIDE benefit. 
  4. If approved for respite care, we will coordinate a schedule of services directly between the family caregiver and agency. There is no out of pocket expenses or deductibles.
  5. Families may choose to engage in additional private pay in-home care services above and beyond what GUIDE benefits cover.

Receive the support you need for Alzheimer’s and dementia care

At ComForCare, we are dedicated to helping you and your loved ones navigate the challenges of memory loss, dementia, and Alzheimer’s disease. Our compassionate agency understands the complexities of dementia-related behaviors and are committed to fostering a strong partnership with family caregivers. We collaborate with you to create personalized strategies for daily routines and self-care for your loved one. Plus, we’re always available to answer your questions, provide valuable resources, and offer expert guidance on in-home care.

Call us today to learn more about GUIDE and start the enrollment process.

 


Sources:

¹ https://www.cdc.gov/caregiving/php/public-health-strategy/index.html 

GUIDE Model FAQ

Covered Costs, Eligibility, and Enrollment

There are no out-of-pocket costs for eligible Medicare beneficiaries enrolled in the GUIDE Model.

While GUIDE services will appear on your Medicare Explanation of Benefits (EOB), they are fully covered under your existing Medicare benefits. Enrolled participants receive:

  • Up to $2,625 annually per qualified resident for CMS-covered respite care services.
  • 24/7 access to geriatric-trained physicians and nurse practitioners.
  • Comprehensive dementia care via provider consultations across 125+ medical specialties (including psychiatry and neurology).
  • Ongoing medication reviews and personalized care support.

The enrollment process typically takes 2 to 3 weeks from start to finish:

  1. Eligibility Check: First, your Medicare coverage will be confirmed for eligibility.
  2. In-Home Assessment: Once eligibility is confirmed, a one-hour in-home assessment will be scheduled and provided.
  3. Medicare Submission: The assessment results are submitted to Medicare on your behalf to finalize enrollment.

To qualify for the $2,625 GUIDE respite benefit, participants must meet the following criteria:

  • Dementia Stage: Must meet standard GUIDE requirements and be diagnosed with moderate-to-advanced dementia.
  • Caregiver Status: Must have an identified primary caregiver who is an unpaid family member or friend.
  • Assessment: The primary caregiver must complete the required questions during the initial GUIDE assessment.

Once enrolled, an interdisciplinary care team works closely with the participant and their primary caregiver to create and manage a personalized care plan.

Depending on your needs, services may include:

  • Care coordination and navigation support.
  • Caregiver education, training, and emotional support.
  • Vetting and connections to local respite services.
  • Continuous medication reviews.
  • Referrals to essential community resources, such as specialized transportation, housing assistance, and meal delivery services.

GUIDE bridges the gaps in traditional healthcare by providing dedicated dementia care coordination, 24/7 clinical support, and caregiver relief.

Partner Organization's interdisciplinary team partners directly with the participant’s existing primary care doctors and specialists. This collaborative approach ensures that clinical assessments, respite care, and emergency support are perfectly synchronized, preventing unnecessary hospital visits and reducing caregiver burnout.

Each office is independently owned and operated and is an equal opportunity employer.

Jennifer Cepeda - Brown
ComForCare Home Care (Lee's Summit, MO)
Operated By: 
Jennifer Cepeda-Brown
Office Phone:  
(816) 890-9698
688 SE Bayberry Lane, Suite 104
Lee's Summit, MO 64063

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