Guiding an Improved Dementia Experience (GUIDE) Model at MUSC Health
What is GUIDE?
The Guiding an Improved Dementia Experience (GUIDE) Model is a Medicare program offering enhanced services for individuals living with dementia and their caregivers.
Program goals
- Enhance caregiver support
- Improve the quality of life for those with dementia
- Help individuals remain in their homes and communities longer
- Up to $2,625 per year* for services like in-home care or adult day centers, allowing caregivers to take necessary breaks.
- A dedicated care navigator working alongside a geriatrician or neurologist to coordinate care and connect you to services.
*to qualify for respite benefit, CMS (Medicare) must place the patient in moderate for severe complexity tier.
Who qualifies
- Medicare A and B beneficiaries only
- Have a diagnosis of dementia as confirmed by one of MUSC’s GUIDE practitioners during your in-person or virtual enrollment visit
- Must not reside in assisted living or memory care facilities.
- Must not be enrolled in Medicare Advantage, including Special Needs Plan (SNPs)
- Have Medicare as primary insurance
- Must not be enrolled in Program of All-Inclusive Care for the Elderly (PACE)
- Had not elected the Medicare Hospice Benefit
- Is not a long-term nursing home resident (defined as a residence in a nursing home that is not paid for under the Medicare skilled nursing facility benefit)
- Must reside in the tri-county Charleston area under one of the covered service areas
If you qualify
How to enroll
To enroll in the MUSC GUIDE program, please speak with your primary care physician. Your physician will review your needs and, if appropriate, place a referral to MUSC GUIDE. Once the referral is complete, here is what to expect next:
- If you are eligible, you will be contacted by the GUIDE team to schedule an in-person visit or virtual/telehealth enrollment visit. During this visit, we will create a comprehensive plan with you.
- The results of the examination will be sent to Centers of Medicare and Medicaid (CMS) for approval and tier assignment
- CMS will confirm you are a good fit for the program within a month of submission
- Once approved by CMS, MUSC will send you a letter stating that you have been accepted into the program.
- Once letter is sent, you will receive your first care navigation call from one of MUSC’s Guide Care Navigators
What to expect
Care Navigator
A dedicated professional to coordinating care and connect you to services.
A Dedicated Support Line
Access to assistance when you need it.
Caregiver Education
Training and resources to help caregivers manage responsibilities and stress.
Respite Services
Up to $2,625 per year for services like in-home care or adult day centers, allowing caregivers to take necessary breaks. CMS must place patients in a moderate or severe complexity tier for patients to receive annual respite benefits.
Community Resources
Assistance with connecting to services such as transportation and meal programs.
For providers
Next steps for providers who wish to refer their patients to GUIDE:
- Review the eligibility criteria to determine if patient is qualified.
- If yes, place "ambulatory referral to GUIDE program" within Epic.
- External referrals with supporting clinical documentation of dementia can be faxed to our team at 843-628-2460 or emailed directly to GUIDE@musc.edu if you are unable to place an order or referral in Epic.
- For any questions, please email - GUIDE@musc.edu.
