If you (or your parent/spouse) received a letter from the Centers for Medicare & Medicaid Services (CMS) saying you “may be eligible for free dementia care support” through a new Medicare program called GUIDE, it’s not junk mail. It’s a Medicare Innovation Center outreach about the GUIDE Model (Guiding an Improved Dementia Experience).
Here’s what it actually means, what it doesn’t mean, and what to do next if you’re in Gloucester County (Woodbury, Sewell, Mullica Hill, Deptford, Washington Township, Glassboro, Pitman, West Deptford, and nearby).
What the GUIDE program is (plain English)
GUIDE is designed to help people living with Alzheimer’s disease or related dementias stay safer at home while reducing caregiver burnout. It does this through:
- a care navigator (someone you can call when things get messy, not just a brochure)
- caregiver education/training and ongoing support
- 24/7 access to a support line
- connection to community resources (meals, transportation, etc.)
- respite support for qualifying caregivers, up to an annual cap
The big “gotcha”: you must have Original Medicare (not Medicare Advantage)
This is where most families get tripped up.
In general, GUIDE eligibility requires:
- Medicare Parts A and B as the primary coverage (Original Medicare)
- a dementia diagnosis (Alzheimer’s or related dementia)
- not enrolled in Medicare Advantage (Part C)
- not on hospice
- not enrolled in PACE
If your loved one has a Medicare Advantage plan (even if it’s through a familiar brand name), that often makes them ineligible for GUIDE.
What “respite” means in real life
Respite is a planned break for the unpaid caregiver (spouse, adult child, relative, friend). Under GUIDE, CMS reimburses participating programs for respite services up to $2,500 per year for eligible patients (program rules apply). Respite can include in-home care, adult day programs, or facility-based respite, depending on what’s available locally.
Translation: it’s meant to give caregivers breathing room, not replace 24/7 caregiving.
What to do if you got the letter
1. Confirm what type of Medicare they actually have- Look at the card: Original Medicare is the red/white/blue Medicare card.
- If they have a separate plan card that says “Medicare Advantage,” “HMO,” or “PPO,” that’s usually Part C (and typically not GUIDE-eligible).
CMS maintains GUIDE program info and a participant list. The outreach letters often include a short local list, but the CMS list is the source of truth.
3. Ask the GUIDE provider exactly how respite is delivered locallySome GUIDE participants deliver respite through their own staff; others coordinate with local home care agencies or adult day centers.
Gloucester County-specific help you can use right now (with or without GUIDE)
Even if GUIDE isn’t a fit (common if someone is on Medicare Advantage), Gloucester County has legitimate caregiver supports worth calling about:
- Gloucester County Caregiver Support Program (including adult day service support, JACC, and other caregiver resources)
- Gloucester County Division of Senior Services / ADRC resources (county “front door” for aging/disability help)
- NJ Division of Aging Services: directory of County Offices on Aging
Local next step if you want help sorting this out quickly
If you’re local and you want a fast, practical answer (eligible vs not, and what options you actually have in Gloucester County), get the person’s Medicare card(s) in front of you and confirm whether it’s Original Medicare or Medicare Advantage first. That single step prevents 80% of the wasted phone calls.