The Guiding an Improved Dementia Experience (GUIDE) Model is a voluntary, nationwide model designed to enhance quality of care by improving quality of life for people with dementia and reducing the burden and strain on their caregivers.

For more information, please visit the GUIDE Model Website: GUIDE (Guiding an Improved Dementia Experience) Model | CMS

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Patient Eligibility Requirements for the GUIDE Model:

A patient is eligible to receive services under the GUIDE Model if they meet the following criteria:

• Has dementia, as confirmed by attestation from a clinician on the GUIDE Participant’s GUIDE Practitioner Roster;

• Is enrolled in Medicare Parts A and B (not enrolled in Medicare Advantage, including Special Needs Plans, or PACE programs) and has Medicare as their primary payer;

• Is residing in a Private Residence or an approved Residential Care Community that has agreed to partner with a GUIDE Participant (not a long-term nursing home resident and not residing in a Memory Care Unit),

• Has not elected the Medicare hospice benefit, and

• Is not currently aligned to another GUIDE Model Participant.

A patient will not be disqualified from the model based on other Alzheimer's treatment and/or medications.

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How to sign up for GUIDE services?

• Step 1: Check if you meet eligibility criteria. You or someone you know may qualify if the following apply: 

  • Referral from a doctor that you have dementia, confirmed by a GUIDE doctor.

  • Medicare is your primary insurance, including enrollment in Medicare Parts A and B.

  • Not enrolled in the Medicare hospice benefit or Program of All-Inclusive Care for the Elderly (PACE).

  • Not living in a long-term nursing home.

• Step 2: Find a provider serving your area (see Participant List here). Contact a GUIDE doctor or care team to schedule a comprehensive assessment. Assessments can be made in person or virtually, based on your preference. GUIDE is completely voluntary – you can stop at any time, and your regular Medicare benefits continue as usual. You can still see any doctor or hospital that accepts Medicare.

• Step 3: Start GUIDE. Your GUIDE doctor or care team will submit your information to CMS to confirm your eligibility. Your GUIDE doctor or care team will notify you if you are officially enrolled.

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Please see a Fact Sheet for Patients and Caregivers here https://www.cms.gov/priorities/innovation/files/guide-model-patient-caregiver-fs.pdf (PDF)