TL;DR: Does insurance cover memory care? This guide explains the real costs of memory care and what insurance, Medicare, and other programs may (and may not) pay for, helping families plan ahead. Readers will learn how pricing compares to other senior living options and discover practical ways to manage expenses.

  • Memory care is more expensive than independent or assisted living due to 24/7 medical support and dementia-specific services
  • Most standard insurance plans do not cover memory care room and board
  • Medicare and Medi-Cal may cover limited services like evaluations, medications, or short-term care—not full residency
  • Long-term care insurance, VA Aid & Attendance benefits, and PACE programs can help offset costs
  • Comparing communities and prioritizing essential services can make memory care more affordable

Any eldercare setting comes with an inherent cost that family will need to consider. Most residential senior communities are akin to a college campus, with residential accommodations and meals often covered as part of a resident’s monthly rent payment.

It’s with this fact in mind that many families of those living with dementia often wonder, “does insurance cover memory care?” For families looking to plan for their loved one’s care and balance their finances accordingly, it’s an important question to ask.

In this guide, we will explore the key factors that affect memory care costs, discuss what insurance policies may cover, and offer tips for families looking to plan and manage their memory care expenses.

Understanding the Cost of Memory Care

As we mentioned at the top of this article, memory care represents a specialized wing of senior care. In memory care settings, residents are attended not by mere care partners but by skilled medical professionals who hold the training and licensure needed to treat residents living with dementia. Their skills are offered as a round-the-clock custodial level of support for residents living with dementia.

As such, the cost of memory care tends to be higher than independent living or assisted living settings. Here in the state of California, for instance, the average monthly price for each is as follows:

  • Independent Living: $3,612
  • Assisted Living: $7,024
  • Memory Care: $9,358

As you can see, memory care tends to, on average, cost more than lower levels of residential care, and with good reason.

Understanding Memory Care Insurance Coverage

With prices remaining high for monthly memory care housing, it stands to reason that many family caregivers ask, “Does insurance cover memory care?” After all, medical insurance is often thought of as a means of reducing medical bills, and memory care is, as we discussed, inherently health custodial in nature.

While plans and unique coverages vary from provider to provider and plan to plan, generally speaking, insurance does not cover memory care costs for most residents. Of course, it’s always pertinent to check directly with your provider, as coverage options, laws, and plan specifics commonly change. You can also inquire with additional providers if your current provider’s memory care insurance coverage doesn’t meet your family’s needs.

Understanding Medicare Memory Care Coverage

Families often wonder, “how much does Medicare pay for memory care?” The truth of the matter is, two of the most common coverages here in California (Medi-Cal and Medicare) do not cover room and board for memory care.

However, some hope remains:

  • Medi-Cal may cover some memory care services within a community
  • Medicare may cover doctor-ordered evaluations, medication management, and short-term rehabilitation stays

Of course, as laws and stipulations commonly change, it helps to look for the most recent regulations regarding what is and isn’t covered by Medi-Cal and Medicare with regard to memory care. While Medicare memory care coverage may not be open and shut today, that isn’t to say this will always be the case.

Tips for Paying for Memory Care

While insurance coverages may not be a viable means of covering the entirety of memory care services, additional levels of support may be available. Consider these tips for paying for memory care to make the overall cost more tenable:

  • VA benefits to veterans and their spouses may qualify them for the Aid and Attendance benefit, which may cover memory care costs.
  • Those with Long-Term Care Insurance (LTCI) can rely on their policies to cover the costs for residential memory care costs.
  • The Program of All-Inclusive Care for the Elderly (PACE) has medical and social services available to seniors in our state.
  • Not all memory care communities are alike. Tour a few communities and look for a balance of high quality services and settings without the bells and whistles of premium communities to help offset costs.

Find a Quality Memory Care Setting Your Family Can Afford

If your loved one requires better memory care support in a setting designed to be inclusive, you are welcomed to tour Summerfield Memory Care of Redlands. Our happy community of residents living with dementia is supported 24/7 by a skilled and compassionate team of memory care professionals. Here, residents find comfort, dignity, and enjoyment in floorplans that come with fair and straightforward pricing.

Discover a better setting for your loved one living with dementia. Learn more about our memory care community here.