A plan and a point of contact
A comprehensive assessment, a personalized care plan and a care navigator to help coordinate care.
DEMENTIA & CAREGIVER SUPPORT
A little more support.
A clearer next step.
Caring for someone living with dementia can feel overwhelming. Medicare’s GUIDE Model may offer extra care coordination and caregiver support for people who qualify.
Sources reviewed October 25, 2026
What is GUIDE?
GUIDE stands for Guiding an Improved Dementia Experience. It is a Medicare model for dementia care—not a new insurance plan. Participation is voluntary, and your regular Medicare benefits continue.
CMS · MEDICARE
Official information to keep or share
Read, save or print the original CMS handouts. These PDFs keep their government branding and have not been edited by Ask Mary Anything.
01
What support may be included?
A participating GUIDE care team tailors services to the person and caregiver.
Caregiver education and support
Training, guidance and support for family members and other unpaid caregivers.
24/7 access to help
Access to a care team member or helpline—not round-the-clock care in the home.
Community connections
Help connecting with resources such as meals or transportation. GUIDE does not automatically pay for those services.
Respite, when eligible
Temporary relief for an unpaid caregiver through approved services, subject to an annual cap and assessed eligibility. It is not a cash payment.
02
Who may qualify?
This is a starting point—not a diagnosis or an eligibility decision. A participating provider assesses the person, obtains consent and submits information for CMS confirmation.
The basic requirements
- Dementia confirmed by a clinician on the participating GUIDE team.
- Medicare Parts A and B, with Medicare as the primary payer.
- Living in a private home or an approved residential care community partnered with a GUIDE participant.
Current limits
- Not enrolled in Medicare Advantage (including Special Needs Plans) or PACE.
- Has not elected the Medicare hospice benefit and is not aligned with another GUIDE participant.
- Not living in a long-term nursing home or a memory care unit.
Living in assisted living or another residential care community? Since July 2026, the community must have an approved GUIDE partnership. Residents may receive other GUIDE support, but not GUIDE respite services.
03
What does it cost?
GUIDE-covered services, including eligible GUIDE respite, have no patient cost-sharing. This does not make all medical care, home care, meals or transportation free. Ask the participating team which services are covered and which may have separate costs.
Who gets respite?
Respite is not available to every enrollee. It is for qualifying people with an unpaid caregiver in assessed moderate- or high-complexity care tiers. The care team confirms eligibility, approved services and the current annual limit before care is arranged.
04
How to take the next step
- Find a participating GUIDE provider using the official CMS participant list. Confirm service in your ZIP code and whether new patients are being accepted.
- Ask the provider for a comprehensive assessment. Discuss the person’s Medicare coverage, living situation and care needs.
- If you choose to participate, the provider documents consent and asks CMS to confirm eligibility. The provider tells you when enrollment is confirmed.
Open the CMS participant listOfficial spreadsheet · XLSX
A listing is not an endorsement or a promise of local availability. Service areas and openings must be confirmed directly.
Before your first call
- Do you serve our ZIP code and accept new GUIDE patients?
- Does this living arrangement qualify?
- What is needed for the assessment and consent?
- Which services are covered, and what costs could fall outside GUIDE?
- Is respite available for this person, and how is it arranged?
- Is support available in our preferred language?
Official sources & important notes
- CMS GUIDE overview
- CMS GUIDE frequently asked questions
- CMS GUIDE participant list (XLSX)
- CMS GUIDE payment methodology (PDF)
Program rules and availability can change. The CMS FAQ includes newer eligibility details that may not appear in the general handouts. Confirm current requirements with a participating provider.
Ask Mary Anything is an independent educational resource. This page is not a CMS or Medicare enrollment service and does not imply government endorsement or that Mary is a GUIDE provider. Information is not medical advice or a guarantee of eligibility, services or coverage.