The GUIDE Program for Dementia Care
Guiding an Improved Dementia Experience (GUIDE) is a Centers for Medicare & Medicaid Services model launched in 2024. It provides coordinated care for people living with dementia and meaningful support for their caregivers.
What is the GUIDE Model?
The GUIDE Model is a voluntary, nationwide alternative payment model from the Centers for Medicare & Medicaid Services. It aims to improve quality of life for people with dementia, reduce caregiver strain, and help avoid unnecessary hospitalizations.
Our physician-led team brings coordinated dementia care to patients and their families, with a dedicated Care Navigator at the center of the plan.
Our goal is to help families living with dementia feel supported, informed, and never alone at every stage of the journey.
A dedicated Care Navigator
One person to coordinate services, appointments, and support.
24/7 helpline
Access for patients and caregivers at any hour.
Caregiver respite services
Help to prevent caregiver burnout.
Comprehensive care planning
A dementia care plan developed by a physician-led team.
Medication management
Medication review and safety assessments.
Americans living with Alzheimer’s dementia
Unpaid caregivers providing dementia care in the U.S.
Estimated annual cost of dementia care in the U.S.
Figures cited by the Alzheimer’s Association. Please verify current figures before publishing.
Is your loved one eligible?
GUIDE is available to Medicare beneficiaries who meet the criteria below. See the CMS guidelines for complete eligibility details.
Dementia diagnosis
Has been diagnosed with Alzheimer’s disease or a related dementia by a qualified clinician.
Traditional Medicare
Enrolled in Medicare Parts A and B. Not enrolled in a Medicare Advantage plan, a PACE program, or hospice.
Not in a long-term nursing home
Does not live in a long-term skilled nursing facility. Home and assisted living settings are accepted.
Medicare as primary payer
Medicare must be the patient’s primary health insurance payer for GUIDE services.
The five pillars of GUIDE care
Care navigation
A dedicated Care Navigator coordinates medical appointments, specialist referrals, community resources, and benefits, so families spend less time managing logistics.
Comprehensive care planning
Individualized dementia care plans covering medication management, behavioral symptoms, safety assessments, advance care planning, and goals of care.
Caregiver support
Education, training, and emotional support for caregivers, with respite services to help prevent burnout.
24/7 helpline
A helpline for urgent clinical questions, behavioral crises, or reassurance at any hour.
Community resource linkage
Connections to local support groups, adult day programs, legal and financial planning resources, and other community services.
How to enroll in GUIDE
Enrollment is simple, and our team guides families every step of the way.
Call or contact us
Reach the clinic nearest you and ask about the GUIDE Program.
Eligibility review
We verify Medicare enrollment, diagnosis, and living situation to confirm GUIDE eligibility.
Consent and enrollment
Complete a brief enrollment form and Medicare consent.
Meet your care team
Your Care Navigator schedules an initial assessment and introduces your care team.
Ongoing support begins
Your care plan launches with regular visits, monitoring, and 24/7 support.
GUIDE Program FAQ
Is there any additional cost for GUIDE?
GUIDE services are covered under traditional Medicare, with no additional cost beyond normal Medicare cost-sharing. A supplemental plan is not required, though one may further reduce out-of-pocket costs. Please verify your coverage with our team.
What types of dementia qualify?
All types of dementia can qualify, including Alzheimer’s disease, vascular dementia, Lewy body dementia, frontotemporal dementia, and mixed dementia, as long as the diagnosis is documented and Medicare eligibility requirements are met.
My loved one has a Medicare Advantage plan. Do they qualify?
GUIDE currently requires traditional Medicare (Parts A and B) as the primary payer. Patients on Medicare Advantage or PACE plans are not eligible. Call us to talk through your specific situation.
Can we keep our current primary care doctor?
Within GUIDE, our providers serve as the coordinating care team and work with your existing specialists to keep care integrated. Contact us to discuss your specific situation.
What if our loved one lives in an assisted living facility?
Assisted living residents can be eligible. GUIDE is not available to people living in a long-term skilled nursing facility. Call us to confirm what is possible for your family.
Help your loved one live better with dementia.
Our team is ready to answer your questions, confirm eligibility, and guide you through enrollment.
GUIDE is a Centers for Medicare & Medicaid Services model. Eligibility and benefits are determined by Medicare. This page is for general information.