Medicare Part B covers most dementia testing, including wellness visits, depression screenings, and brain scans. Additional coverage may help pay for treatments, medications, and additional costs of dementia testing.

Dementia is a term used to describe several medical conditions characterized by cognitive decline. Dementia can negatively affect thinking, memory, language, judgment, and even behavior.

If you’re enrolled in Medicare and require dementia testing, your plan will cover wellness visits, depression screenings, and other tests your doctor may want to order.

Read on to learn more about which tests are used to diagnose dementia, as well as which parts of Medicare cover dementia testing.

According to the National Institute on Aging, there are two elements of dementia screening:

  • checking for underlying medical conditions, such as nutrient deficiencies or medication side effects
  • testing for cognitive decline through physical examinations, cognitive assessments, and brain scans

Medicare generally covers all the services that are used during dementia screening and testing, including:

  • annual wellness visits
  • cognitive impairment assessments
  • yearly depression screenings
  • diagnostic nonlaboratory tests

Which parts of Medicare cover dementia testing?

Medicare offers various types of coverage, from hospital insurance to prescription drug coverage and more. Let’s explore which Medicare parts cover dementia testing.

  • Medicare Part A: Medicare Part A covers inpatient hospital care. Dementia testing is typically done in outpatient settings, but may also be performed during an inpatient hospital stay where Part A can provide coverage before Part B takes over.
  • Medicare Part B: Medicare Part B (medical insurance) covers preventive, diagnostic, and treatment-related care. This includes dementia testing.
  • Medicare Part C: Also known as Medicare Advantage, Part C covers all Medicare Part A and Part B services. This means any dementia testing services mentioned above that are covered under original Medicare will also be covered under Medicare Advantage.
  • Medicare Part D: covers prescription drugs. While outpatient prescription drugs are generally not used for dementia testing, most drugs used in the treatment of dementia are covered under Part D. Be sure to check your drug plan’s formulary for more information on which medications are covered.
  • Medigap: Also known as supplemental insurance, Medigap doesn’t cover dementia testing. However, it may help cover some of the out-of-pocket costs associated with those tests. If you need help covering Medicare costs, you can compare plan offerings here.

Out-of-pocket costs for dementia testing can vary, as your doctor will ultimately decide which tests are necessary for your diagnosis.

Here’s a glance at what those costs may look like both with and without Medicare.

With Medicare

Although Medicare covers almost all services associated with dementia testing, there are still costs associated with your plan that you may owe out of pocket. This includes:

  • Part A: No premium for most people and a deductible of $1,676
  • Part B: A premium of $185 or more and a deductible of $257
  • 20% of the Medicare-approved amount for the Part B coinsurance after you meet the deductible
  • variable plan costs for the Part C premium and deductible
  • variable coinsurance or copayment costs for prescription drugs needed during testing
  • variable plans costs for the Medigap premium

Unless you have a Medigap plan that covers your plan deductibles, you must pay these amounts upfront before Medicare pays for any dementia testing.

Without Medicare

Without Medicare or another health insurance plan with similar coverage, you will likely have to pay for 100%of the costs of your dementia testing unless you’re privately insured.

While annual wellness exams can be quite affordable, the more costly options — such as brain scans — can cost hundreds or thousands of dollars.

If your doctor or care team believes that you may be showing signs of dementia, there are a variety of tests that they can perform.

Generally, dementia testing includes:

  • physical examinations to gather vitals, check balance, test reflexes, and determine any other accompanying physical symptoms
  • laboratory tests to check for hormones, vitamins, and other important chemicals that may be associated with symptoms of dementia
  • cognitive or neuropsychological assessments to determine the level of cognitive function or decline
  • brain scans, such as CT, MRI, or PET scans, to rule out or identify any changes in the brain that are causing dementia symptoms
  • psychiatric evaluations to determine if another mental health condition, such as depression or anxiety, is causing symptoms of cognitive decline

Although your primary care doctor can diagnose dementia, they may want to consult with a team of specialists to confirm your diagnosis. This may include consulting with geriatric specialists, neurologists, and neuropsychologists.

Finding help if your loved one may have dementia

A diagnosis of dementia can be difficult to process, but there is support available to help you throughout treatment and beyond.

The Alzheimer’s Association has some helpful resources for individuals with dementia and their loved ones, including:

  • Helpline. Its 24/7 helpline can be reached at 800-272-3900. This free helpline offers education, support, and other resources for family members of individuals living with Alzheimer’s.
  • Support groups. It offers both individual and caregiver support groups. These nationwide support groups are offered both in-person and virtually.
  • Education. It also has a virtual library that features education on the different types of dementia, especially Alzheimer’s disease.

Dementia is the loss of cognitive and behavioral functioning due to changes in the healthy neurons of the brain. It can show up in difficulty with memory, communication, language, focus, reasoning, and visual perception.

Early signs also include:

  • short-term memory loss
  • trouble finding words
  • forgetting things or names,
  • difficulty with familiar tasks, multitasking, or making decisions
  • mood changes
  • confusion or disorientation in new places.

Is a cognitive test required by Medicare?

Medicare’s Annual Wellness Visit (AWV) always includes a cognitive assessment.

Is the blood test for Alzheimer’s covered by Medicare?

Currently, there isn’t a specific blood test that can definitively diagnose dementia. But, doctors may request various blood tests to evaluate cognitive function, rule out other potential causes of symptoms, and assess overall health and well-being. These blood tests should generally be covered under Part B.

Dementia screening can be performed by your doctor or care team as part of your annual wellness exam.

If you’re a Medicare beneficiary, you’re covered for this annual wellness exam and for a variety of other tests that can be used to diagnose dementia.

Contact your doctor or provider directly for more information on which types of dementia tests are available under your Medicare plan.