Question and Answer

What services will Medicare pay for to diagnose dementia or Alzheimer's disease?

Question: 
Recently I have been having trouble with my memory. I often feel disoriented and confused. My children are worried and want me to go to a doctor and see if I have the beginning stages of Alzheimer's. What will Medicare cover?

Answer:
Medicare will cover medically-necessary doctor's visits and laboratory tests needed to diagnose any suspected disease or condition, including dementia or Alzheimer's disease. Some methods to diagnose dementia or Alzheimer's disease may include:

  • Consultations with a primary care physician and possibly a neurologist or other specialists.

  • A mental status evaluation to assess your cognitive capabilities including your:
    • sense of time and place;

    • ability to remember, understand and communicate;

    • ability to do simple math problems.

  • A physical examination, which includes the evaluation of your nutritional status, blood pressure, and pulse to provide additional information about problems other than Alzheimer's that may be causing dementia.

  • A brain scan to detect other causes of dementia such as stroke.

  • A psychiatric evaluation, to assess any mood disorders or other emotional factors that could cause dementia-like symptoms or may accompany Alzheimer's disease.

  • A positron emission tomography (PET) scan to evaluate the cause of memory disorders that cannot be determined from any other diagnostic test.

Note: Medicare will cover 80 percent for your initial consultations and evaluation, 80 percent for medication management and 65 percent (in 2013) for ongoing mental health treatments like psychotherapy.

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