Insurance & Financial Planning
Understanding coverage and benefits
Planning for the cost of care
Navigating insurance decisions over time
Why planning early matters
A dementia diagnosis can reshape finances, insurance needs, and long-term planning. From diagnostic tests and medications to home care, respite services, and long-term care facilities, costs can add up quickly. Planning early gives families more options — and more control. Learn what insurance can cover, and what it doesn’t.
Return
Next
What does insurance actually cover?
Insurance coverage for dementia care depends on the type of care — and the type of insurance.
Medicare
Medicaid
Private
Coverage often changes as needs evolve — from diagnosis to advanced care.
Return
Next
Understanding Medicare
Medicare generally starts for people at 65, and people sometimes buy additional insurance on top of Medicare.
People who are employed in the US pay into Medicare during their working lives, and then pay an additional premium during retirement years.
It does not cover long-term care and anything considered non-medical, even though this can be necessary for some people living with dementia.
Return
Next
Understanding Medicaid
What is Medicaid?
“Medicaid is one of the only significant public sources of money that will help you with the long-term care costs associated with dementia. Medicaid benefits start when you can show you’re financially absolutely in need. It’s really intended to be a last resort for families who are paying for long-term care but there are some significant differences from Medicare.
Michael Guerrero
READ MORE
Elder Care Resource Planning
Return
Next
Paying for diagnosis and treatment
Getting an accurate diagnosis can be expensive — and coverage isn’t guaranteed.
Amyloid PET scans may or may not be covered, depending on insurance and state policies.
New Alzheimer’s drugs are covered by Medicare and Medicaid under specific conditions because the drug is FDA-approved.
Return
Next
Planning for long-term care
Long-term care is one of the biggest financial challenges families face. Otions include:
Home care
Assisted living
Nursing homes
Planning ahead can help families avoid financial challenges later.
Read more
Return
Next
Should you consider long-term care insurance?
Long-term care insurance can help cover services Medicare doesn’t — but it’s not right for everyone. Consider:
For some families, options beyond insurance may be a better fit—consulting an elder law attorney can help with long-term care planning.
Return
Next
An expert’s perspective
Hear from Kim Natovitz, a financial planner at TriBridge Partners, about long-term care insurance.
"We all have priorities in terms of looking at our overall financial plan, but don’t let perfection be the enemy of good. Certainly having some long-term care insurance would be better than not having anything at all. Most people begin looking at long-term care insurance about a decade before they retire… There are some short-term care policies, which will provide benefits that will be for a year or less, that can be less expensive.”
Kim Natovitz
READ MORE
Associate at TriBridge Partners
Return
Next
When one man’s insurance denied his Leqembi
Dan Jaworski was diagnosed with early-onset Alzheimer’s disease at age 54. Since he is under 65, he doesn’t qualify for Medicare, which covers Kisunla as well as the associated amyloid PET brain scans. His private insurer, Florida Blue, denied him coverage. Jaworski qualified for a Kisunla trial at the K2 Research Center where he has access to the drug as part of the study. “It was very disappointing,” Jaworski said of his battle with his insurer. “I got lucky that I found the trial. You’ve got to be your own advocate.”
READ MORE
Return
Next
Insurance gaps and discrimination
Insurance systems don’t affect everyone equally.
- Some insurers can legally discriminate based on biomarkers, even before symptoms appear.
- Access to diagnostic testing and care often depends on ZIP code, income, and state policy.
- These gaps disproportionately affect underrepresented and marginalized communities.
READ MORE
Return
Next
Insurance gaps and discrimination
The US Genetic Information Non-Discrimination Act helps but fails to protect against blood-based biomarkers, cerebral spinal fluid biomarkers, or neuroimaging, according to Stanford University Law professor Hank Greely.
“The act only deals with employment and health insurance, but it doesn’t deal with life insurance and probably most significantly for the Alzheimer’s community, it doesn’t deal with disability insurance or long-term care insurance.”
Hank Greely
READ MORE
Stanford University Professor
Return
Next
End-of-life care and hospice decisions
Financial planning includes preparing for end-of-life care. Hospice services can provide comfort-focused care, but dementia patients are unlikely to meet Medicare’s stringent criteria for hospice, which is designed to limit hospice to patients who are expected to die within six months. On top of this, Medicare’s criteria require that people with dementia require help with basic things like toileting and walking, and have a terminal complication of dementia such as aspiration pneumonia, recurrent UTIs, or bed sores.
READ MORE
Return
Next
Learn More
Understanding insurance coverage options and their financial implications won’t eliminate uncertainty — but it can help families face dementia with more clarity and fewer surprises.
Return
Next
Want to keep learning?
Visit
beingpatient.com
for the latest news and information on brain health and Alzheimer's disease
Return
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Transcript
Insurance & Financial Planning
Understanding coverage and benefits
Planning for the cost of care
Navigating insurance decisions over time
Why planning early matters
A dementia diagnosis can reshape finances, insurance needs, and long-term planning. From diagnostic tests and medications to home care, respite services, and long-term care facilities, costs can add up quickly. Planning early gives families more options — and more control. Learn what insurance can cover, and what it doesn’t.
Return
Next
What does insurance actually cover?
Insurance coverage for dementia care depends on the type of care — and the type of insurance.
Medicare
Medicaid
Private
Coverage often changes as needs evolve — from diagnosis to advanced care.
Return
Next
Understanding Medicare
Medicare generally starts for people at 65, and people sometimes buy additional insurance on top of Medicare.
People who are employed in the US pay into Medicare during their working lives, and then pay an additional premium during retirement years.
It does not cover long-term care and anything considered non-medical, even though this can be necessary for some people living with dementia.
Return
Next
Understanding Medicaid
What is Medicaid?
“Medicaid is one of the only significant public sources of money that will help you with the long-term care costs associated with dementia. Medicaid benefits start when you can show you’re financially absolutely in need. It’s really intended to be a last resort for families who are paying for long-term care but there are some significant differences from Medicare.
Michael Guerrero
READ MORE
Elder Care Resource Planning
Return
Next
Paying for diagnosis and treatment
Getting an accurate diagnosis can be expensive — and coverage isn’t guaranteed.
Amyloid PET scans may or may not be covered, depending on insurance and state policies.
New Alzheimer’s drugs are covered by Medicare and Medicaid under specific conditions because the drug is FDA-approved.
Return
Next
Planning for long-term care
Long-term care is one of the biggest financial challenges families face. Otions include:
Home care
Assisted living
Nursing homes
Planning ahead can help families avoid financial challenges later.
Read more
Return
Next
Should you consider long-term care insurance?
Long-term care insurance can help cover services Medicare doesn’t — but it’s not right for everyone. Consider:
For some families, options beyond insurance may be a better fit—consulting an elder law attorney can help with long-term care planning.
Return
Next
An expert’s perspective
Hear from Kim Natovitz, a financial planner at TriBridge Partners, about long-term care insurance.
"We all have priorities in terms of looking at our overall financial plan, but don’t let perfection be the enemy of good. Certainly having some long-term care insurance would be better than not having anything at all. Most people begin looking at long-term care insurance about a decade before they retire… There are some short-term care policies, which will provide benefits that will be for a year or less, that can be less expensive.”
Kim Natovitz
READ MORE
Associate at TriBridge Partners
Return
Next
When one man’s insurance denied his Leqembi
Dan Jaworski was diagnosed with early-onset Alzheimer’s disease at age 54. Since he is under 65, he doesn’t qualify for Medicare, which covers Kisunla as well as the associated amyloid PET brain scans. His private insurer, Florida Blue, denied him coverage. Jaworski qualified for a Kisunla trial at the K2 Research Center where he has access to the drug as part of the study. “It was very disappointing,” Jaworski said of his battle with his insurer. “I got lucky that I found the trial. You’ve got to be your own advocate.”
READ MORE
Return
Next
Insurance gaps and discrimination
Insurance systems don’t affect everyone equally.
READ MORE
Return
Next
Insurance gaps and discrimination
The US Genetic Information Non-Discrimination Act helps but fails to protect against blood-based biomarkers, cerebral spinal fluid biomarkers, or neuroimaging, according to Stanford University Law professor Hank Greely.
“The act only deals with employment and health insurance, but it doesn’t deal with life insurance and probably most significantly for the Alzheimer’s community, it doesn’t deal with disability insurance or long-term care insurance.”
Hank Greely
READ MORE
Stanford University Professor
Return
Next
End-of-life care and hospice decisions
Financial planning includes preparing for end-of-life care. Hospice services can provide comfort-focused care, but dementia patients are unlikely to meet Medicare’s stringent criteria for hospice, which is designed to limit hospice to patients who are expected to die within six months. On top of this, Medicare’s criteria require that people with dementia require help with basic things like toileting and walking, and have a terminal complication of dementia such as aspiration pneumonia, recurrent UTIs, or bed sores.
READ MORE
Return
Next
Learn More
Understanding insurance coverage options and their financial implications won’t eliminate uncertainty — but it can help families face dementia with more clarity and fewer surprises.
Return
Next
Want to keep learning?
Visit
beingpatient.com
for the latest news and information on brain health and Alzheimer's disease
Return