What to Expect from the GUIDE Model for Dementia Care
No Cost for Medicare Beneficiaries
Both the Dementia Care Management and personal care/respite services are provided at no cost for Medicare beneficiaries and their caregivers.
Eligibility Criteria
- Beneficiaries must be enrolled in Fee-for-Service Medicare (Part A and B, not a Medicare Advantage plan, PACE, or hospice).
- Beneficiaries must have dementia, be it previously diagnosed or suspected.
- Medicare recognizes that many people with dementia have never been formally diagnosed.
- Beneficiaries may enroll in the program with or without a caregiver. Caregivers are defined in GUIDE as unpaid individuals, such as family members or friends, who provide care or assistance to someone with dementia. Caregivers do not need to live near the eligible GUIDE beneficiary.
Benefits of Our Comprehensive Dementia Care Program
The GUIDE Model is a comprehensive initiative designed to enhance the quality of life for Medicare beneficiaries with dementia, as well as providing substantial support to their caregivers. Here’s what patients, caregivers, and partner organizations can expect:
Comprehensive Interdisciplinary Support
Patients and caregivers will benefit from individualized assessments and care plans, as well as ongoing support provided by an interdisciplinary team specialized in dementia care.
Dedicated Care Navigator
Each beneficiary/caregiver dyad is paired with an experienced Care Navigator who will provide assessment, coordination, referral to community resources, caregiver support and education, and frequent communication.
24/7 Support Line
A 24/7 phone line will be available to provide immediate support, answer questions, and address concerns.
Caregiver Support
The model provides comprehensive caregiver education and skills training on a broad range of topics including home safety, managing distressed behaviors, identifying and obtaining help, emergency services, assisting with activities of daily living, and self-care and stress management.
Respite Payment
The program offers a new respite care payment for caregivers that provides approximately 83 hours of personal care annually. This payment may also be used to complement staffing for GUIDE beneficiaries who live in senior living facilities.
Care Coordination
The GUIDE Model focuses on closely coordinating with the patient’s primary and specialty care teams, including importantly during transitions of care between hospitals, facilities, and separate offices.
Personalized Community Support
The model also emphasizes personalized referrals and connections to community-based services and supports such as meals, transportation, personal care, adult day programs, and housekeeping services.
For detailed information and application guidelines, visit the CMS GUIDE Model FAQs.