Critter Corner: Medicare Care Planning Benefit for People with Alzheimer’s

Dear Magic,

My mother, Ingrid, was diagnosed with Alzheimer’s. We know that there is no cure and that it only gets worse as time progresses. We’d like to plan in advance to make sure she gets the support services and medications she needs, and any non-medical treatments to improve her quality of life. We’d also welcome any caregiving tips that can be provided. Does Medicare cover any services to help us plan for these things?

Keir Planning

Dear Keir,

Effective Jan. 1, 2017, individuals with cognitive impairment have access to care planning with a medical professional through Medicare. Although this benefit has been around for three years, very few physicians or patients know about it.

What is Care Planning for Alzheimer’s?

Care planning provides individuals diagnosed with cognitive impairment and their caregivers with information about medical and non-medical treatments, and clinical trials and support services available in the community — all of which can contribute to a higher quality of life.

According to the Alzheimer’s Association, “(p)eople who receive proper care planning are shown to have fewer hospitalizations and emergency room visits, and better medication management. In addition, because dementia can complicate the management of other chronic conditions, care planning is key to coordinating a person’s overall care.”

Clinicians who treat Medicare beneficiaries with cognitive impairment, including Alzheimer’s disease and other dementias, are eligible for reimbursement under Medicare using the G0505 code. These clinicians include physicians; physician assistants; nurse practitioners; clinical nurse specialists; and certified nurse midwives.

What Happens During a Care Planning Session?

During a care-planning session the provider will go over options for support services, medication management, possible clinical trials the person may be eligible to enroll in.

You’ll also want to address safety management – including any changes needed to accommodate the effects of cognitive impairment – caregiver stress and needs, and non-medical treatments or options that may improve the person’s quality of life.

In addition, there are many strategies, including things that don’t involve medication, that the care partner and families can do to help the person at home.

What exactly will the assessment address?

The G0505 code requires clinicians to provide detailed, person-centered care planning that includes several areas:

• evaluating cognition and function;
• measuring neuropsychiatric symptoms;
• medication reconciliation;
• evaluating safety (including driving ability);
• identifying caregivers and caregiver needs;
• identifying and assessing care directives;
• planning for palliative care needs; and
• referrals to community services for both the beneficiary and his or her caregiver.

To take advantage of this benefit, be sure to discuss care planning and the G0505 code with your health care provider. Call 800.272.3900 or visit alz.org/medicare to learn more.

Plan in Advance for a Loved One with Alzheimer’s

Hopefully, this session will be helpful for families who have loved ones with Alzheimer’s or another form of dementia. Please also realize that persons with dementia and their families face special legal and financial needs. At the Farr Law Firm, we are dedicated to easing the financial and emotional burden on those suffering from dementia and their loved ones. To learn more about Alzheimer’s planning at the Farr Law Firm, please call us at 703-691-1888 to make an appointment with Mr. Farr for a no-cost initial consultation.

Hop this helps!

Magic

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