Specialized support for dementia patients — and the families who care for them
A dedicated clinical team, a personal care navigator, caregiver training, and paid respite hours — all covered by Medicare, all delivered at home.
Covered by Medicare · No additional cost to patients or families
A Medicare program built to help people with dementia live better at home — and give their caregivers real support.
GUIDE (Guiding an Improved Dementia Experience) is a program created by Medicare to improve care for people living with dementia and to support the family members and caregivers who care for them. Rather than waiting for a crisis, GUIDE provides proactive, ongoing clinical support — a dedicated team that comes to you, coordinates everything, and works directly with your existing caregivers.
Six things the GUIDE program provides — at no extra cost.
A dedicated care navigator
Your single point of contact for scheduling, coordination, insurance questions, and anything in between. One person who knows your situation and stays with you.
One person to call for everythingRegular in-home clinical visits
Our physicians and nurse practitioners come to your home — assessing cognition, managing medications, monitoring for changes, and updating your care plan.
No transportation needed24/7 access to clinical support
When something changes at 2am — confusion, agitation, a fall — you have a clinical team to call that already knows your loved one.
Around-the-clock coverageCaregiver training & support
We train family members and home aides on managing day-to-day challenges — communication strategies, safety planning, recognizing warning signs, and reducing caregiver stress.
For family members & home aidesFree paid respite hours
The GUIDE program provides paid caregiver relief hours — so family caregivers can take a genuine break while a qualified caregiver steps in. These hours are funded through the program, at no cost to you.
Paid relief hours for family caregiversBehavioral health support
Depression, anxiety, and difficult behavioral changes are common with dementia. Our behavioral health team provides support via telehealth, coordinated directly with your medical care plan.
Integrated, not a separate referralIs this program right for you or your loved one?
The GUIDE program is designed for Medicare patients living with dementia. Here's a plain-language breakdown.
You likely qualify if…
- You or your loved one has been diagnosed with Alzheimer's or another form of dementia
- You are enrolled in original Medicare (Part A and Part B)
- You live in NYC, Nassau County, or Westchester County
- You have a family member, aide, or caregiver involved in daily care
- You have difficulty leaving home for regular doctor visits
You may not be eligible if…
- You do not have a dementia diagnosis — though we can help evaluate
- You are not enrolled in original Medicare fee-for-service
- You are already receiving equivalent services through another GUIDE participant
- You live outside our current service area
Four simple steps.
- 1
Submit a referral or call us
You can refer yourself, or a family member, doctor, hospital, or home care agency can refer on your behalf. Use our referral form or call 844-262-5700, Monday–Friday, 9am–6pm.
- 2
We confirm eligibility and schedule a visit
Our team verifies your Medicare coverage and dementia diagnosis — usually within 1–2 business days — then schedules a home visit at a time that works for you.
- 3
A clinician visits and builds your care plan
A physician or nurse practitioner comes to your home, reviews your history, assesses current needs, speaks with caregivers, and builds a personalized plan including goals, safety considerations, and caregiver support.
- 4
Your ongoing care begins
From that point forward, you have a dedicated care navigator, regular visits, 24/7 clinical access, and paid respite hours — all coordinated with your existing doctors, aides, and family.
Frequently asked questions.
Does my current doctor stay involved?
Yes. We work alongside your existing doctors, sharing care notes and coordinating on medications and treatment. You don't have to give up any existing relationship.
What does this cost?
The GUIDE program is covered by Medicare. You pay standard Medicare cost-sharing — typically nothing beyond existing copays or deductibles. No enrollment fees, no subscription costs, no charges for the care navigator or 24/7 support line.
How many paid respite hours do we get?
The number of paid respite hours available depends on your care plan and specific needs. Our care navigator will walk you through what you're entitled to during your initial enrollment visit. These hours are funded through the GUIDE program — not billed to you or your family.
We already have a home health aide. Does this replace them?
No. GUIDE adds clinical and coordination support on top of your existing home care. We work directly with your aide as part of the care team — no disruption to your current agency relationship.
Can we leave the program if it's not right for us?
Yes. Participation is entirely voluntary and you can disenroll at any time without affecting your Medicare coverage or other services.
Ready to get started?
If you or a loved one is living with dementia, you don't have to navigate it alone. A referral takes minutes.
Refer a PatientOr call 844-262-5700 · Monday–Friday, 9am–6pm · 24/7 for enrolled patients