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Serving Northern Virginia, Fredericksburg & Winchester 703-662-7500 - Available 24/7

Medicare GUIDE Program

Dementia care navigation for patients, families, and healthcare professionals.

The Medicare GUIDE (Guiding an Improved Dementia Experience) program is a CMS Innovation Center initiative designed to provide comprehensive, coordinated care for people living with dementia and meaningful support for their caregivers. Through care navigation, respite services, medication education, and home safety assessments, the GUIDE program helps families navigate the complex world of dementia care — all covered by Traditional Medicare at no additional cost to eligible beneficiaries.

Stop Guessing, Start Knowing
Feel confident with expert guidance from a dementia care navigation professional by your side.
Temporary Care
Respite relief for family caregivers: 83 hours of in-home personal care, 9 days of assisted living, or 32 days of adult daycare.
Medication Education
Demystify medications and understand their purpose with expert guidance tailored to your loved one's care plan.
Live Safely
Create a dementia-friendly home with our safety and fall risk assessments, plus personalized recommendations.
You're Not Alone
Navigate dementia care with our help, connecting you to doctors, nurses, social workers, and community resources.
Expert Training
Receive expertly developed education for family caregivers on how to care for your loved one with dementia.
Enrollment

Medicare GUIDE Intake Form

To determine eligibility and begin enrollment, please confirm all four criteria below, then complete the intake form.

Eligibility Requirements — all 4 must apply
Patient is covered under Traditional Medicare as primary insurance
Patient is not currently on hospice
Patient is not currently in a nursing home with level 4 care and above
Patient has a diagnosis of or suspicion of dementia
Please confirm all four criteria above to unlock the intake form

Patient Information

Caregiver / Contact Information

The Medicare GUIDE program requires a monthly care navigation phone call to maintain active participation. If approved, what is the preferred day and time for these monthly calls?

Clinical Assessment

Functional Status — Check all that apply

Medical History — Does the patient have any of the following?

Mental Health History — Does the patient have any of the following?

Dementia Screening

For each question below, please indicate whether this applies to the patient.

Problems with judgment (e.g., bad financial decisions, problems with thinking)
Less interest in hobbies or activities
Repeats the same things over and over (questions, stories, or statements)
Trouble learning how to use a tool, appliance, or gadget (e.g., computer, microwave, remote control)
Forgets correct month or year
Trouble handling complicated financial affairs (e.g., balancing checkbook, paying bills)
Trouble remembering appointments
Daily problems with thinking and/or memory

Not sure if you qualify? Call us at 703-662-7500 — our Intake Nurse Navigator will review your situation at no cost.

Get in Touch

Request Care

A live person answers 24/7. No voicemail. No call centers. We'll respond promptly.

Privacy Notice: This form is for general inquiries only. Please do not include medical records, diagnoses, insurance ID numbers, Social Security numbers, or other sensitive health information. For clinical questions, call us directly at 703-662-7500.

For immediate assistance, call 703-662-7500 (24/7).