Will Medicare or Medicaid help with my wife's Alzheimer's care even though we're not of retirement age yet?

Louisl717 asked...

My wife has been diagnosed with Alzheimer's and is getting worse as far as confusion and difficulties with ADL's are concerned. I am currently still employed And my wife is receiving Social Security disability, but not Medicare. Am I in a Catch 22 with her since she and I are both only 60 and can't afford to retire? What should I do since I am really concerned about her when I am at work? Will Medicare help pay for her daily care? What should I do? My annual gross income is $55000 not including her Social Security disability payment of $800 a month. We do not have an out of pocket long term health care policy. I really could use some advice since Medicare and Medicaid are complicated and don't seem to care about Alzheimer's patients. Must we be destitute and homeless to get help?

Expert Answer

Mary Koffend is the president of Accountable Aging Care Management (AACM), an eldercare consulting and care management firm that works with elder clients and their families to find the best care providers and services to meet their needs.

Do not give up hope as there are options. Medicare and Medicaid are only a part of the possible care for a person with Alzheimer's. After your wife has been receiving Social Security disability payments for 24 months, your wife will be eligible for Medicare benefits. Medicare is a traditional health insurance and does not provide specific Alzheimer benefits. It does provide excellent coverage for doctor's visits and once your wife is eligible for Part A and B, she can also get drug coverage through a separate plan or take an advantage plan that includes A, B and the drug coverage. Discuss the best choices with your drug store and your wife's physician to see what they see as the most comprehensive plans for your wife's specific medications and medical treatment. Although this is in the future, there are other things to do now.

One option for you to consider now is adult day care for your wife. There are some excellent programs in most cities. Adult day care provides targeted activities, a meal, and medication management during the day. Here are some excellent articles about these programs. www.caring.com/local/adult-day-care. The cost of these programs is much less that paying a private caregiver for your wife and gives you much peace of mind so you can stay focused on your work to continue the income needed for you and your wife.

Also you should discuss the Medicaid program with the director of the day care center. You may need the advice of an attorney specializing in elder law. Medicaid generally does not pay for adult day care, but you need to check out the options in your state. The director of the day care center may know about the Medicaid requirements as well as the name of a good attorney to advise you. Medicaid planning is a very specialized area of the law and most lawyers are not specifically knowledgeable in this area of the law. You will want to contact an Elder Law lawyer who is a member of the National Academy of Elder Law Attorneys to help you. You can find a NAELA lawyer near you by going to www.naela.org.