The Center for Medicare and Medicaid Services (CMS) has begun mailing notices to 3 Million beneficiaries nationwide who are enrolled in Original Medicare (i.e., not in a Medicare Advantage plan) and who may be eligible for services under the Guiding an Improved Dementia Experience Model, or GUIDE. Avisery encourages professionals to let their clients or patients know that these are legitimate CMS notices that will be sent annually. Click here to see an example notice.
What is the GUIDE Model for Dementia Care?
The GUIDE Model aims to improve support for community-residing Original Medicare beneficiaries and their caregivers through a set of comprehensive services not normally available under Medicare. A set of approved providers began offering GUIDE services in 2024; the list then expanded in 2025. GUIDE services that would not normally be covered by Original Medicare include:
Interdisciplinary care teams
Care navigation
24/7 access
Caregiver support
Addressing health-related social needs
CMS offers an infographic that explains the GUIDE model in comparison to the common dementia care experience under Original Medicare and also a fact sheet for patients and their caregivers.
Why Are These Notices Being Sent?
The GUIDE Model involves a patient outreach and engagement strategy that includes annual letters from CMS to targeted Original Medicare beneficiaries that CMS has determined may benefit from GUIDE services. To receive a letter, an individual must meet the following criteria:
Have an ICD-10 dementia diagnosis noted within the last three years of Medicare claims data
Live within the service area of an approved GUIDE provider
Meet other GUIDE eligibility criteria including not residing in a nursing home or participating in the Program for All-Inclusive Care for the Elderly (PACE)
The goal of the CMS letter is raise awareness about the potential advantages of the GUIDE Model and to share contact information for GUIDE providers operating within the recipients local area.
If you have questions or need help counselingolder adults and adults with disabilities on Medicare, Medicaid, or other health benefits programs, reach out to Avisery's "Ask the Expert"service for professionals at
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