Under Medicare, a person can see a geriatric doctor and receive referrals for covered screenings and support. That said, Medicare does not cover geriatric care management.
Geriatric care is a medical field specifically designed to address the unique health needs of older adults. This is needed more than ever since research indicates that about
Geriatric care doctors
While Original Medicare does cover geriatric medical care, it doesn’t cover geriatric care management. This article discusses what Medicare does and does not cover for geriatric healthcare.
Under both Original Medicare and Part C, a person can see a geriatric care doctor, also called a geriatrician, under Medicare Part B and undergo screenings and treatments if deemed medically necessary.
A geriatrician is a primary care doctor who specializes in treating older adults. A person might consider seeing a geriatrician if they are an older adult living with several health conditions or illnesses, take several medications, experience challenges with thinking or reduced mobility, or are living with another disability.
Medicare Part B covers medical care, which includes doctor’s visits. As part of Part B coverage, a person is entitled to one “Welcome to Medicare” preventive visit when they first enroll in Medicare and one annual wellness visit thereafter.
They can choose a geriatric care doctor to conduct these screenings. In addition, Part B also covers general visits with a doctor if they accept Medicare. A person can search for participating doctors specializing in geriatric medicine in your area on the Medicare.gov website.
Geriatric care management is when healthcare professionals assist a person in managing their chronic conditions by coordinating care with other professionals such as pharmacists, nurses, or social workers.
Original Medicare (parts A and B) does not provide specialized geriatric care management programs. That said, a person can enroll in Medicare Advantage (Part C), which is an alternative to Original Medicare (Parts A and B).
Private insurers manage Part C plans. Most private health insurance plans typically
However, some Part C plans may include additional benefits that Original Medicare does not. For this reason, it is possible that some Part C plans may offer geriatric care management programs. A person can look at the available plans in their area and their benefits on the Medicare.gov website.
Medicare Part B and Part C do offer services that do not constitute geriatric care management but do offer similar benefits to qualifying individuals.
Home healthcare
A home health agency can help coordinate care with a doctor for someone needing ongoing support at home. Home health aides also assist with daily activities like bathing and dressing.
That said, Medicare Part B requires that a person also get skilled nursing care to qualify for home care services. while skilled nurses handle medical tasks such as administering IV medications, checking blood sugar, or managing tube feedings Original Medicare covers skilled nursing up to 8 hours daily, with a weekly limit of 28 to 35 hours.
PACE
Some people may qualify for the Program of All-Inclusive Care for the Elderly (PACE). PACE can also provide a healthcare team that organizes and provides for a person’s home care. The program collaborates with seniors and their families to create a personalized care plan, encompassing all services covered by Medicare and Medicaid, along with some extra assistance.
Typically, each PACE team manages a small number of cases, allowing them to focus closely on each person’s preferences and requirements.
Part B covers visits with a geriatric care doctor. Certain visits, such as the annual wellness check, are fully covered if the person pays the monthly premium of $185 in 2025. For other medical care, a person also has to meet the deductible of $257, after which Part B covers 80% of any covered treatment or service.
With Part C, coverage for medical care comes from private insurance, meaning premiums, deductibles, and coinsurance vary depending on the plan.
According to the Centers for Medicare & Medicaid Services (CMS), the average monthly premium for Part C plans is around $17 in 2025. Additionally, to be enrolled in a Part C plan, a person must still pay the Part B premium. Some Part C plans may cover the Part B premium.
Cost of geriatric care management
According to the American Caregiver Association, geriatric care managers typically charge between $100 and $145 per hour. Since Medicare does not cover geriatric care management, patients must pay this cost out of pocket.
Cost of other coordinated care
Part B covers home care in most cases if a person pays the premium and meets their deductible.
Part A, on the other hand, will cover the first 100 days of home healthcare. A person’s coverage is dependent on meeting the Part A deductible of $1,676. The individual also needs to be a hospital inpatient for at least 3 consecutive days or have a Medicare-covered stay in a skilled nursing facility, provided the services begin within 14 days of discharge. Most people don’t pay a premium for Part A.
With regard to PACE, people on Medicaid will not have to pay a premium for long-term care. People on Medicare, on the other hand, will pay a monthly premium and a premium for medications covered under Part D. The national base beneficiary premium for Part D is $36.78 in 2025.
Geriatric care is a branch of medication tailored to meet the specific health needs of older adults. Doctors specializing in geriatric care evaluate a person’s cognitive functions and physical health, focusing on age-related risk factors. They may also perform mental health assessments and provide guidance on medications.
They might also refer individuals to other services such as diabetes management, nutrition, and cardiovascular therapy.
Medicare generally covers doctor’s visits, including geriatric care specialists, but it does not cover specific geriatric care management programs geared toward coordinating care. That said, there are covered home care services that offer a similar benefit.