Caring for someone with dementia is a long road, and most families walk it without a map. Medicare is testing a program meant to change that. It is called the Guiding an Improved Dementia Experience (GUIDE) Model, and it gives people living with dementia, and the family members who care for them, a care team and practical support.
This guide explains what the program is, who can use it and how it works alongside non-medical home care. The program details below come from the Centers for Medicare & Medicaid Services (CMS), which runs the model.
What Is the GUIDE Model?
According to CMS, GUIDE is a voluntary, nationwide model that tests the impact of providing comprehensive services and supports for people with dementia and their caregivers. It began on July 1, 2024, and will run for eight years.
The aim is to help people with dementia stay safely in their homes and communities longer, and to ease the load on family caregivers.
What Families Receive
CMS lists these services for people enrolled with a participating GUIDE provider:
- Care navigation: a person or team who helps coordinate care and connects you to community resources.
- A 24/7 support line: someone to call when a question or a hard moment comes up at night or on a weekend.
- Caregiver training and education: practical help for the family member providing day-to-day care.
- Respite services: up to $2,500 a year, so caregivers can take a break.
Who Is Eligible?
CMS states that a person must have dementia, confirmed by a clinician with the GUIDE provider, and must also:
- Be enrolled in Medicare Parts A and B, with Medicare as the primary payer. People in Medicare Advantage plans (including Special Needs Plans) or PACE programs are not eligible.
- Live in a private residence, or in an approved residential care community that partners with a GUIDE provider. Long-term nursing home residents are not eligible.
- Not have elected the Medicare hospice benefit.
- Not already be enrolled with another GUIDE provider.
How to Sign Up
- Check the eligibility criteria above.
- Find a provider serving your area. CMS publishes a participant list on its GUIDE Model page. Contact the provider to schedule a comprehensive assessment, which can be in person or virtual.
- Start GUIDE. The provider submits your information to CMS to confirm eligibility and tells you when you are enrolled.
The program is voluntary. CMS notes that you can stop at any time, that your regular Medicare benefits continue as usual, and that you can still see any doctor or hospital that accepts Medicare. For questions about your own benefits, call 1-800-MEDICARE.
Where Home Care Fits In
GUIDE organizes care and supports the caregiver. It does not replace the daily, hands-on help that many people with dementia need at home: a steady routine, help with bathing and meals, company during the day and safety in the evening. That is what non-medical home care provides.
Many families use both. A GUIDE care team helps with the plan, and a caregiver at home helps carry it out. Home Care Squad LLC provides dementia care and respite care for families across Oklahoma City.
If you would like to talk it through, call Home Care Squad LLC at 405-855-1050 or set an appointment. We are available 24 hours a day, 7 days a week.
Frequently Asked Questions
Is the GUIDE Model available in Oklahoma?
GUIDE is a nationwide model, but services come through participating providers, each with its own service area. Check the CMS participant list or call 1-800-MEDICARE to find out whether a provider serves your ZIP code.
Can someone with a Medicare Advantage plan join GUIDE?
No. CMS states that the person must be enrolled in Medicare Parts A and B and not in a Medicare Advantage plan or PACE program.
Does GUIDE pay for a caregiver at home every day?
No. GUIDE includes respite services up to $2,500 a year, which gives family caregivers short breaks. Ongoing daily home care is arranged separately.