Medicare 2026

Worried About a Parent's Memory? What to Know About Medicare's Cognitive Assessment and Care Plan Visit

If you've noticed a parent repeating questions, missing bills, or getting turned around in familiar places, you're not alone — and you don't have to figure out the next step by yourself. Medicare covers specific visits designed to look for memory and thinking problems, and, when needed, to dig deeper and build a written plan of care. Here's a plain-English guide to what's covered, who can come along, and how to start the conversation with a provider.

Start with the yearly Wellness visit

Medicare's yearly Wellness visit is a good entry point. It's covered once every 12 months at no cost to the patient when the provider accepts assignment, and it already includes a cognitive assessment to look for signs of dementia, including Alzheimer's disease. One timing note: the first yearly Wellness visit can't happen within 12 months of Part B enrollment or the "Welcome to Medicare" preventive visit.

During this visit, the provider may ask about memory, mood, and day-to-day function, and may do a brief screening. Medicare specifically lists these as possible signs of cognitive impairment worth checking out:

• Trouble remembering
• Difficulty learning new things
• Trouble concentrating
• Struggles managing finances
• Problems making decisions about everyday life

If any of these show up — or if the provider has concerns based on their exam — Medicare covers a separate, more thorough visit.

The separate cognitive assessment and care plan visit

This is the deeper look. Medicare Part B covers a distinct visit with a health care provider to fully review cognitive function, establish or confirm a diagnosis (such as dementia or Alzheimer's disease), and develop a written care plan. After the Part B deductible — $283 in 2026 — the patient pays 20% of the Medicare-approved amount. (The 2027 Part B deductible and standard premium haven't been announced yet; CMS typically releases those figures in the fall.)

A thorough cognitive assessment visit may include:

• A focused exam and review of medical history and all current medications (some drugs can affect thinking).
• A check for conditions that can mimic or worsen cognitive symptoms, such as depression, anxiety, or delirium.
• A conversation about social supports, including what the usual caregiver can realistically provide.
• Creating a written care plan.
• Help developing or updating an advance care plan.
• A referral to a specialist when needed.
• Information about community resources such as adult day health programs and support groups.

Expect this visit to take longer than a routine appointment. Families often say it's the first time someone has sat down with them and connected the dots.

Bring someone with you

Medicare explicitly notes that a person can bring a spouse, friend, or caregiver to a cognitive assessment to help listen to information and answer questions. This is more than moral support. A second set of ears catches instructions that get missed, and the companion can share observations the patient might not volunteer — like a near miss behind the wheel or trouble managing a pillbox. If you're the adult child, consider writing down a short list of specific examples before the appointment ("got lost driving home from church in August"; "forgot a grandchild's name twice last month").

Ask about the GUIDE Model

Medicare suggests asking the provider whether they participate in the Guiding an Improved Dementia Experience (GUIDE) Model. This model is designed to offer additional support to some people living with dementia and their unpaid caregivers, including coordinated care and caregiver resources. Not every practice participates, but it's worth the question.

How this fits with the rest of Medicare

Cognitive assessments are covered under Part B, which is part of Original Medicare. People enrolled in a Medicare Advantage plan get the same covered benefits, though cost sharing and in-network rules are set plan by plan. If you're helping a parent weigh coverage choices, it's worth understanding the broad trade-offs without assuming one path is better:

• Original Medicare (often paired with a Medigap policy and a stand-alone Part D plan): Generally broad provider access nationwide for anyone who accepts Medicare; Medigap can make out-of-pocket costs more predictable but is a separate premium.
• Medicare Advantage: Often bundles drug coverage and may include extras, but typically uses provider networks and prior authorization rules that vary by plan.

Neither is universally "better" — the right fit depends on a parent's doctors, medications, budget, and travel patterns.

A few program-level reminders for the year ahead:

• Annual Enrollment (Open Enrollment) for 2027: October 15 – December 7, 2026; changes take effect January 1, 2027.
• Part D out-of-pocket cap: $2,100 in 2026, rising to $2,400 in 2027. The most any Part D plan may charge as a deductible in 2027 is $700, and the Part D base beneficiary premium (used in the late-enrollment penalty calculation) is $41.33.
• Social Security COLA: A 3.6% cost-of-living adjustment takes effect in January 2027.

If your parent has Medicaid or Extra Help

Since 2025, people with Medicaid or Extra Help have a monthly Special Enrollment Period to move to Original Medicare with a stand-alone Part D plan, or to switch stand-alone Part D plans. Full-benefit dual-eligible individuals can join an integrated Dual Eligible Special Needs Plan (D-SNP) in any month. This flexibility can matter a lot if a dementia diagnosis changes which providers or pharmacies a family needs.

What should you do next?

• Call the primary care provider and ask to schedule a cognitive assessment and care plan visit, or to discuss memory concerns at the next yearly Wellness visit.
• Bring a trusted family member or friend, plus a written list of recent examples and all medications (including over-the-counter items).
• Ask about the GUIDE Model and about local community resources such as adult day health programs and caregiver support groups.

For official details on what's covered, enrollment windows, and plan comparisons, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. This article is educational only and isn't affiliated with any government agency.