Medicare and Cognitive Assessments: What Families Need to Know

Most older Americans want to be tested for dementia. They recognize the benefits of early detection. Furthermore, they look to their physicians to make them aware of these tests and to advise them as to when and how to take them.

The problem is that 80% of older Americans have yet to take a cognition test.

These troubling findings are the result of the University of Michigan National Poll on Healthy Aging, published in a 2023 report and presented at the Alzheimer’s Association International Conference in Amsterdam.

Other studies support these findings as well. One, conducted by the Government Accountability Office (GAO) and cited by Senior Housing News reported that only 2.4% of Medicare beneficiaries diagnosed with Alzheimer’s disease had received their initial assessment through Medicare.

That is because many Americans with Medicare coverage don’t realize that it includes cognitive assessment services to individuals who are showing signs of cognitive impairment. It even covers a shorter test for those who aren’t yet experiencing any cognitive challenges.

Why the disconnect?

As it turns out, it is more complicated than one might think. Here is where much of that disconnect lies:

For healthcare professionals:

• Time constraints. At least 60 minutes are needed to conduct assessments. In a busy doctor’s office, that can be challenging.
• Insufficiently trained personnel.
• Billing limitations that prohibit a collaborative approach to diagnosis.

For Medicare beneficiaries:

• Lack of awareness. Many Medicare recipients are simply unaware of eligibility.
• The fear of the social stigma connected to a diagnosis of dementia.
• Underserved populations. Black and Hispanics are less likely to receive assessments.

It is time to increase awareness, education, and accessibility to testing.

But is this happening? To a degree it is, but more work is needed to make a meaningful difference. The Department of Health and Human Services (HHS), along with the Centers for Medicare and Medicaid Services (CMS) are engaged in outreach programs targeting providers as well as eligible Medicare recipients.

Our Anthem Memory Care communities are active in the industry working to educate and bring greater awareness Medicare beneficiaries of their eligibility for dementia testing.

Dr. Tam Cummings encourages aging Americans to take advantage of available testing.

Dr. Cummings, dementia expert, gerontologist, and author, is an advocate for early detection of Alzheimer’s disease and other forms of dementia. She urges individuals to be more proactive and assertive with their physicians and take a more active role in managing their cognitive health. Dr. Tam has a series of tools that identify key behaviors that are known to be indicators of dementia.

There are many benefits to getting tested. Here are just a few:

• Early access to treatment options. While we don’t yet have a cure, there are new medications coming into the market that can reduce the rate of cognitive decline.
• Better prepared emotionally. Knowing what to expect early on gives an individual time to gain greater understanding of the disease and how it will impact them and their families.
• More time to plan. This includes planning for specialized memory care, as well as financial support.

At Anthem Memory Care, we urge families with aging loved ones to encourage them to be tested. The earlier an individual with Alzheimer’s is diagnosed the more time they will have to plan for the future and develop a strategy to help them live their best lives going forward.