Medicare GUIDE dementia care and caregiver respite in Santa Clara County

A directory listing, not an eligibility decision.

UniHealth can identify a possible match, but the responsible program makes the final decision.

What to know

Why it may fit: Your circumstances can be checked against the program’s published guidelines.
What to do next: Medicare's GUIDE program helps people with dementia and the family members who care for them. You get a care navigator, a person who helps you find care. You also get a 24/7 help line and caregiver training. Some caregivers get paid breaks, called respite. GUIDE services and respite are free. Other Medicare care keeps its usual costs. It is for people with Original Medicare.
Who runs it: Centers for Medicare & Medicaid Services, through participating GUIDE dementia care programs

What the program may consider

Medicare Parts A and B, not in a Medicare Advantage plan or PACE
A dementia diagnosis, confirmed by the program
You live in the community, not long-term in a nursing home or on hospice
A participating GUIDE program serving Santa Clara County

How to get it

Medicare's GUIDE program helps people with dementia and the family members who care for them. You get a care navigator, a person who helps you find care. You also get a 24/7 help line and caregiver training. Some caregivers get paid breaks, called respite. GUIDE services and respite are free. Other Medicare care keeps its usual costs. It is for people with Original Medicare.

Before you start

You need this first Original Medicare. You need Original Medicare Parts A and B, with Medicare paying first.

How to apply

PhoneMedicare GUIDE help desk: 1-888-734-6433, option 7Ask which GUIDE programs serve your area.
PhoneHICAP free Medicare counseling: 1-800-434-0222Free, unbiased help with Medicare choices.

Getting help

Someone can refer you, with your permission

You or your caregiver can contact a GUIDE program. A doctor or community group can also refer you. The program asks you, your caregiver, or your legal representative to agree to join. You can be in only one GUIDE program at a time.

What happens after you apply

Find a GUIDE program that serves your ZIP code. Many work by video. Ask if they can give care and respite where you live.
YouA helper can help with this
The program checks that you qualify. You cannot be in hospice, or live long-term in a nursing home or a memory care unit. If you live in assisted living or board and care, that home must work with the program.
The program or providerA helper can help with this
You, your caregiver, or your legal representative agree to join this program.
YouA helper can help with this
The care team meets you and your caregiver. They confirm the dementia, check its stage, and ask how the caregiver is doing. Then they make a care plan.
Your doctor or clinicianOnly you can do this
The program signs you up with Medicare. Medicare confirms you qualify and sets your level of support.
MedicareThe program must do this within 60 days after your first full visit.
You get a care navigator and the 24/7 help line. Your caregiver can start training.
The program or providerOnly you can do this
The program sets up paid breaks. This can be a helper at home, adult day care, or a 24-hour stay in a facility. From July 2026 to June 2027, it pays up to $2,625. You pay nothing for this. You may pay for more yourself.
Only if the dementia is moderate or severe, you live in a private home, and have a caregiver
The program or providerOnly you can do this

What only you can do

Agree to join one GUIDE program. You, your caregiver, or your legal representative can agree.
Take part in the first full visit. Your caregiver answers questions about caregiving stress.
Keep Original Medicare. Any change to your Medicare coverage is your own choice. HICAP, the free Medicare counseling program, gives unbiased help.
Schedule and use respite, if you qualify.

How long it takes: Not published. It depends on how soon the program can do your first visit. It then has up to 60 days to sign you up with Medicare.
You are enrolled when: You are enrolled when Medicare confirms you with a GUIDE program and you have a care navigator. For respite, it is when your first paid break has happened.
To keep it: Keep Original Medicare, with Medicare paying first. GUIDE ends if you join a Medicare Advantage plan or PACE. It also ends if you start hospice or move into a nursing home for good. It ends after 8 months with no GUIDE services. Moving to assisted living stops GUIDE respite, and ends GUIDE unless that home works with your program. Moving to memory care ends GUIDE. Respite money resets each July 1 and does not carry over.

Can’t be combined with

Medicare Advantage. GUIDE is not open to people in a Medicare Advantage plan. Changing coverage is your own choice. HICAP gives free, unbiased help.
Dual Eligible Special Needs Plan (D-SNP / Medi-Medi). GUIDE is not open to people in a Special Needs Plan. That is a kind of Medicare Advantage plan.
Chronic Condition Special Needs Plan (C-SNP). GUIDE is not open to people in a Special Needs Plan. That is a kind of Medicare Advantage plan.
Institutional Special Needs Plan (I-SNP). GUIDE is not open to people in a Special Needs Plan. That is a kind of Medicare Advantage plan.
Program of All-Inclusive Care for the Elderly (PACE). GUIDE is not open to people in PACE.

Coming changes

Starting July 1, 2031: New people can join GUIDE only through June 30, 2031. GUIDE is set to end on June 30, 2032.