Understanding the New GUIDE Program: Medicare’s new Dementia Support Model

More than 6.9 million Americans over age 65 are living with Alzheimer’s disease or another form of dementia — and that number is expected to nearly double by 2060, according to the CDC. In California alone, about 720,000 people are currently affected, with Orange County among the fastest-growing regions for dementia-related diagnoses.

For families in South & Coastal Orange County, managing dementia care often means juggling multiple doctors, navigating Medicare rules, and trying to find reliable respite options. Recognizing how overwhelming that can be, the Centers for Medicare & Medicaid Services (CMS) launched the GUIDE Program — short for Guiding an Improved Dementia Experience — to make care more coordinated, compassionate, and supportive for both patients and caregivers.

The CMS GUIDE Program is part of a national effort to bring structured dementia care and caregiver relief to communities like Mission Viejo, Laguna Niguel, San Clemente, Dana Point, and surrounding areas.

What the CMS GUIDE Program Does

The GUIDE Program isn’t a new Medicare plan — it’s a structured care model. Instead of leaving families to juggle care on their own, the program creates a dedicated dementia care team that supports both patients and caregivers.

Here’s what participants can expect:

•  A personalized care plan tailored to the person’s medical and daily needs.
• A care coordinator who serves as a single point of contact for all providers and services.
• Ongoing monitoring and support to keep care consistent and proactive.
• Training and education for caregivers, including practical tips and coping strategies.
• Respite services that give caregivers short breaks to rest or manage personal needs.

The program began nationally in July 2024 and is being introduced across selected healthcare systems — including some in the Orange County area.

Who Qualifies for the GUIDE Program

To be eligible for GUIDE services, an individual must:

1. Be enrolled in Medicare Part A and Part B.
2. Have a diagnosed form of dementia, such as Alzheimer’s, vascular dementia, or Lewy body dementia.
3. Live in a home or community setting (not a full-time nursing facility).
4. Not currently be in Medicare hospice or a PACE (Program of All-Inclusive Care for the Elderly) program.

How to Access GUIDE Services in South Orange County

Because GUIDE is a pilot program, you can’t enroll directly through Medicare. Instead, local healthcare providers must apply and be approved to participate. Senior Helpers of Coastal Orange County is proud to support the GUIDE model by providing in-home respite services on behalf of an approved CMS Dementia Model provider.

If you live in South Orange County — including Mission Viejo, Laguna Niguel, San Clemente, or Dana Point — start by asking your current doctor or memory specialist:

“Are you participating in the CMS GUIDE Program for dementia care?”

If they are, they can confirm eligibility and help you get started. If not, they may refer you to a participating program in the region, like Senior Helpers.

You can also contact:

• UCI Health Memory Disorders Program (Orange & Irvine campuses) – known for dementia and Alzheimer’s care coordination.
• Hoag Hospital’s Cognitive and Memory Program (Newport Beach & Irvine) – offering resources for dementia patients and caregivers.
• Alzheimer’s Orange County – a nonprofit partner that helps connect families with local dementia care programs, caregiver training, and respite options.

As the GUIDE Program expands, more providers in Orange County are expected to join.
 

Why the GUIDE Program Matters for Local Families

For people living with dementia

• Coordinated care that reduces confusion and duplicate appointments.
• Personalized support to stay safe and comfortable at home longer.
• Regular check-ins to prevent emergencies and hospital visits.
• Higher quality of life with consistent monitoring and compassionate care.

For caregivers in South Orange County

• Local training and support resources to help manage daily care.
• Access to respite care, with up to $2,563 per year (as of 7/1/2025) in covered services to give caregivers much-needed breaks.
• Reduced stress thanks to professional care coordination and guidance.
• Direct communication with dementia care teams, so families always know what’s happening.

Costs and Coverage

The CMS GUIDE Program is fully covered by Medicare for those who qualify. There’s no added cost to patients or caregivers for joining.

Behind the scenes, Medicare pays providers a monthly care management fee for each patient, which helps fund care coordination, education, and respite services. This means families receive a higher level of support without extra bills.

Steps to Get Started

If you or someone you care for lives with dementia in South Orange County, here’s how to explore the GUIDE Program:

1. Ask your doctor or neurologist if their clinic participates in the CMS GUIDE Program.
2. Gather key information such as your dementia diagnosis, medications, and caregiver details.
3. Discuss your caregiving challenges with your care team so they can tailor support to your needs.
4. Stay informed — new GUIDE providers are joining regularly across California.

The Bottom Line

The CMS GUIDE Program is a promising step toward better dementia care — not just nationwide, but right here in South Orange County, CA. By focusing on coordination, education, and caregiver support, it is helping families navigate dementia care with more confidence and less stress.

If you’re caring for someone with memory loss in Irvine, Mission Viejo, Laguna Niguel, or nearby areas, now is the time to ask your provider about GUIDE. The right support system can make a world of difference — for both patients and caregivers.