If you're caring for someone with dementia, you've probably felt how many separate pieces there are: appointments, medications, safety, paperwork, and your own exhaustion. Medicare has a program built to take some of that weight. It's called GUIDE, and for families who qualify, Medicare pays for a dementia care navigator, caregiver training and, for some families, a break from caregiving.
This guide explains what GUIDE is, who qualifies, what it costs (nothing for the GUIDE services themselves), and how to find a provider near you.
What Is GUIDE?
GUIDE stands for Guiding an Improved Dementia Experience. It's a Medicare program that started on July 1, 2024 and runs for eight years. The Alzheimer's Association describes it as a free Medicare program that covers the costs of dementia care navigation for people who are eligible. Each family is paired with a dedicated care navigator, who connects them to services such as education programs, support groups and respite care.
GUIDE doesn't replace your regular Medicare. According to CMS's information for patients and caregivers, your Medicare benefits stay the same, and you can still see any doctor or hospital that accepts Medicare. GUIDE adds services on top.
What You Get
CMS lists these services for people in the program:
An assessment and care plan. The care team looks at the person's health needs and builds a plan around them. Caregivers are included in the assessment.
A care navigator. This is the person who helps coordinate care. CMS says you also get 24/7 access to a care team member or a help line when you have questions or need support.
Caregiver education and support. Caregivers, meaning relatives or unpaid friends and neighbors who help with daily activities, can receive personalized training in dementia care and direct contact with a care navigator when they need it.
Connections to community services. The team helps link you to things like meals and transportation, and coordinates between the doctors and other services involved.
Respite care for qualifying caregivers. Respite is a temporary break. It can come from local in-home providers, adult day centers and 24-hour care facilities.
How Much Respite Is Covered?
Respite is covered up to a yearly limit, and only for some families. CMS's payment paper sets the limit at $2,625 per patient for the year that started July 2026, and CMS updates it each year. Families in the moderate and high complexity groups, which means the person has moderate or severe dementia and has a caregiver, are eligible. Your GUIDE provider can tell you whether you qualify.
Does It Cost Anything?
Not for the GUIDE services. The Alzheimer's Association says Medicare makes these services available at no cost for people who meet the eligibility criteria. CMS's payment paper adds that Medicare waives the usual 20 percent coinsurance for GUIDE's monthly payment, and that providers may not charge patients any extra cost sharing for it or for GUIDE respite services.
The rest of your Medicare works as it always has, so regular Medicare costs for other care still apply.
Who Qualifies?
CMS's patient fact sheet lists the basics. You or your loved one may qualify if:
There's a dementia diagnosis. A GUIDE doctor or clinician confirms it. Mild cognitive impairment on its own isn't enough, according to CMS.
Original Medicare is the main insurance. That means Medicare Parts A and B.
The person isn't in Medicare Advantage. CMS's payment paper says people in Medicare Advantage or another Medicare health plan, including Special Needs Plans, can't join. If you're not sure which kind of Medicare you have, look at your Medicare card or ask your plan.
The person isn't in PACE or hospice. People enrolled in the Program of All-Inclusive Care for the Elderly or receiving the Medicare hospice benefit aren't eligible, because those services overlap significantly with GUIDE.
The person isn't living in a long-term nursing home.
The person lives in the provider's service area. Each GUIDE provider serves certain zip codes.
The person isn't already signed up with another GUIDE provider.
Where the Person Lives Matters
According to CMS's payment paper, in the program year that began in July 2026, eligible residences are a private home or an assisted living or similar residential community that CMS has approved as a partner of the GUIDE provider. Memory care units aren't eligible.
That means the answer for someone in assisted living depends on the provider's arrangement with that community. If your loved one lives in one, ask the GUIDE provider whether the community is an approved partner.
How to Find a Participating Provider
GUIDE is delivered by participating organizations, including medical practices, health systems and other dementia care programs. CMS's patient fact sheet says to find a GUIDE doctor or care team on the GUIDE website and contact them to see whether you're eligible.
Look on CMS's GUIDE website. The GUIDE page is the starting point for finding participants. CMS said in its FAQ that it published a participant list, so check that the list you find is current before you rely on it.
Call Medicare. News coverage of the program's launch pointed people to Medicare's toll-free number, 800-633-4227, to search for participants. Call and ask whether there is a GUIDE provider near you.
Call the Alzheimer's Association. Its 24/7 Helpline, 800.272.3900, is free and confidential, and staff can point you to local resources. The Helpline can help you work out next steps.
Ask your doctor. Your current doctor or a local memory clinic may already be a participant or know one.
A caregiver can make the first call. A CMS spokesperson told Fortune that caregivers can contact GUIDE providers on behalf of someone with dementia or suspected dementia.
What Happens Next
CMS's fact sheet describes three steps:
Check your eligibility. Use the list above.
Contact a provider and schedule an assessment. CMS says assessments can be done in person or virtually, based on your preference.
Start GUIDE. The provider submits your information to Medicare to confirm your eligibility, and tells you if you're officially enrolled. CMS's payment paper says the provider must send you written notice within 45 days of CMS's decision. Then you begin receiving support.
Before the assessment, the provider must ask for your consent to receive GUIDE services from them exclusively. CMS's payment paper says they must document your consent in the person's medical record.
Things to Know
It's voluntary. CMS says you can stop at any time, and your regular Medicare benefits continue as usual.
You can switch providers. According to CMS's payment paper, patients have the right to align with a different GUIDE provider at any time. You just tell the provider you're currently with.
You keep your doctors. Being in GUIDE doesn't limit which clinicians you can see.
Questions to Ask a GUIDE Provider
Who will be our care navigator, and how often will they be in touch?
How does the 24/7 line work, and who answers it?
What caregiver training do you offer, and how is it delivered?
Does my loved one qualify for respite, and what options do you offer at home, in an adult day program or in a facility?
Do you serve our zip code, and can the assessment happen at home?
If my loved one lives in assisted living, is that community one of your approved partners?
If You Don't Qualify
If your loved one is in Medicare Advantage, PACE, hospice or a long-term nursing home, GUIDE isn't available while that's the case. Other support is still out there. The Alzheimer's Association Helpline can talk through options, including local support groups and respite programs, and Medicare's number can answer coverage questions. Before changing any insurance coverage to become eligible, talk to a Medicare counselor about what you might lose.
How Elli Cares Fits
Whatever support you use, day-to-day life happens between appointments. Elli Cares helps families and care teams keep track of how someone is doing, with daily check-ins, medication reminders, a shared care circle for family members and notes you can bring to appointments. Elli isn't a GUIDE provider and doesn't enroll anyone or decide eligibility. You can read more on our Seniors and Families page. If you work at an organization that delivers GUIDE, see our GUIDE page.
Frequently Asked Questions
What is the Medicare GUIDE program?
GUIDE is a Medicare program that provides dementia care navigation, caregiver training and support, and respite for eligible people with dementia and their caregivers. It began in July 2024 and runs for eight years.
Is the GUIDE program free?
Medicare covers the cost of GUIDE services for people who qualify, according to the Alzheimer's Association, and CMS says providers can't charge extra cost sharing for them.
Who qualifies for GUIDE?
People with a confirmed dementia diagnosis who have Original Medicare Parts A and B as their primary insurance, aren't in Medicare Advantage, PACE, hospice or a long-term nursing home, and live in an eligible residence within a GUIDE provider's service area.
How do I find a GUIDE provider?
Start with CMS's GUIDE website, call Medicare at 800-633-4227, or call the Alzheimer's Association Helpline at 800.272.3900. Then contact a provider to schedule an assessment.
Can I keep my own doctor if I join GUIDE?
Yes. CMS says your Medicare benefits stay the same and you can still see any doctor or hospital that accepts Medicare.
Can I leave GUIDE?
Yes. CMS says the program is completely voluntary and you can stop at any time.
