Maybe you keep losing your train of thought. Or you have noticed that a parent repeats the same story, or got lost driving to a familiar store. The first step is usually a visit with a regular doctor, such as a family doctor or internist.
This first visit can feel scary. It helps to know that many memory problems have causes that can be treated.5 Even when the cause is dementia, an early answer gives you more time to plan and get support. This page explains what Medicare covers, what to bring, and what to ask.
Key points
- Memory changes that get in the way of daily life are not a normal part of aging. They are worth a doctor visit.5
- Medicare's free yearly wellness visit includes a quick check for signs of dementia.1 If you already have concerns, say so clearly when you book.
- If the doctor finds a problem, Medicare Part B covers a longer visit to look deeper and make a written care plan. Billing staff call it code 99483.2,3
- Bring a list of all medicines and supplements, a short list of changes you have noticed, and a family member or friend if you can.6,7
- Sudden confusion is different. It can signal a stroke or another urgent illness. Call 911 for stroke signs.11
When to make the appointment
Everyone forgets a name or misplaces glasses now and then. With normal aging, it may take longer to recall a word or fact, but daily life goes on as usual.5
It is time to see a doctor when memory or thinking changes start to cause trouble with everyday tasks. Signs include:5
- Asking the same questions again and again
- Getting lost in places you know well
- Trouble following a recipe or directions
- Getting more confused about the time, people or places
- Not taking care of yourself, or doing unsafe things
Grief, stress or a big life change can also make memory worse for a while. If problems last more than a few weeks, see a doctor.5 Our page on mild cognitive impairment explains the stage between normal aging and dementia.
Sudden changes need fast help. Dementia usually comes on slowly, over months or years. Confusion that appears over hours or days may be delirium (a sudden state of confusion often caused by an infection, a new medicine, dehydration or surgery). It can often be treated once the cause is found.10 Call the doctor right away.
Call 911 if confusion comes with sudden trouble speaking, a drooping face, weakness on one side, sudden vision problems, loss of balance, or a sudden very bad headache. These can be signs of a stroke. Do not drive the person to the hospital yourself, and note the time the signs began.11
Option 1: the Medicare yearly wellness visit
If you have Medicare Part B, you can get a yearly "Wellness" visit once every 12 months. You pay nothing if your provider accepts Medicare's approved amount, and the Part B deductible does not apply.1
This visit is a planning talk, not a full physical exam. As part of it, the provider checks your memory and thinking to look for signs of dementia, including Alzheimer's.1 This often includes a short memory test.3 Our page on memory and thinking tests explains the common ones.
- Your first yearly wellness visit cannot be within 12 months of joining Part B or of your "Welcome to Medicare" visit.
- The "Welcome to Medicare" visit is a one-time checkup in your first 12 months of Part B. It reviews your health history and your risk for depression.
- If the doctor does extra tests or treats a new problem during the same visit, you may owe a share of the cost. Ask ahead of time what each part will cost.
Say your concern out loud. A quick check during a wellness visit is meant to catch problems no one has raised yet. Experts say there is not enough evidence to decide whether to screen people who have no symptoms.9 But if you or your family have noticed changes, that is different. The doctor should look into it.9 When you call to book, say: "I would like to talk about memory changes." Ask whether you need a longer appointment.
Option 2: a regular visit about the problem
You do not have to wait for your wellness visit. You can book a regular office visit about memory, just as you would for any other health problem. Unlike the wellness visit, a regular visit is not free. You may owe your usual share of the cost. Call your plan or the doctor's office if you are not sure what you will pay.
What the doctor will do
There is no single test for dementia. Doctors put together several kinds of information, and it may take more than one visit.6,8 At or after the first visit, the doctor may:6,8
- Ask about your history. Past and current health problems, all medicines, diet, alcohol use, and whether relatives had dementia.
- Ask about the changes. What you have noticed, when it started, how often it happens, and whether it is getting worse.
- Talk with a family member, with your permission, about what they have seen.
- Do a physical exam. Blood pressure, pulse, heart and lungs, plus checks of reflexes, balance, eye movement and speech.
- Give a short memory test, such as recalling a short list of words, naming the date, or doing simple math.
- Check for depression, because low mood can cause memory problems too.
- Order blood and urine tests to look for thyroid problems, low vitamin B12, infection, and liver or kidney problems.
- Order a brain scan, such as a CT or MRI, to rule out a stroke, tumor, bleeding or fluid buildup. See brain scans.
The doctor's first job is to look for treatable causes. Depression, sleep problems, medicine side effects, alcohol, thyroid trouble and low vitamin B12 can all affect memory. Memory often improves when these are treated.5,6 Read more in treatable conditions that look like dementia.
Some doctors may also talk about newer tests, such as blood tests for Alzheimer's. These are meant for people who already have symptoms, not for people who feel fine.6 The doctor may refer you to a specialist, such as a neurologist (a doctor for the brain and nerves) or a geriatrician (a doctor for older adults).5,7
The longer visit: cognitive assessment and care plan
If a problem with memory or thinking is found, Medicare Part B covers a separate, more detailed visit. Medicare calls it Cognitive Assessment & Care Plan Services. Doctors and billing offices know it as code 99483.2,3 It can be used for any type of memory or thinking problem, at any stage.3
This visit usually lasts about an hour. A family member or another person who knows you well must be there to help give the history.3 It can happen at the office, at home, in a care facility, or in some cases by telehealth.3 Doctors, nurse practitioners, physician assistants and clinical nurse specialists can provide it.3
During this visit, the provider will:2,3
- Examine you, with a focus on memory and thinking
- Review your history, records and all medicines, and look for ones that may be harmful
- Ask how you manage daily tasks, like bathing, cooking, money and medicines
- Figure out the stage, using standard rating scales
- Check for depression, anxiety and behavior changes
- Talk about safety at home and behind the wheel
- Ask who helps you, and what your caregiver can and wants to do
- Talk about advance care planning (writing down your wishes for future care)
- Give you a written care plan, with referrals to specialists and community help such as adult day programs and support groups
What it costs. After the Part B deductible, you usually pay 20% of the Medicare-approved amount. Your share may differ if you have a supplement plan or other coverage.2 Ask the office what you will owe.
Many families have never heard of this visit. You can ask for it by name: "Can we schedule a cognitive assessment and care planning visit?" Some people living with dementia and their caregivers may also qualify for extra help through Medicare's GUIDE program for dementia care. Ask whether your doctor takes part.2 See what Medicare covers in dementia for more.
What to bring
- A list of every medicine. Include prescriptions, over-the-counter pills, vitamins and supplements, with how often you take each. Or put the bottles in a bag and bring them.4,6,7
- A short list of changes. Write down what changed, when it started, how often it happens, and examples. "Missed three bills since June" helps more than "forgetful."6,7
- Your health history. Past illnesses, surgeries, and recent hospital stays or falls.7
- Family history. Note any relatives who had memory problems or dementia, and at what age.6,7
- Your written questions, with the most important ones at the top.7
- Glasses and hearing aids, so poor vision or hearing does not affect the memory test.
- Your Medicare card and other insurance cards.
- A trusted person. A spouse, adult child or friend can take notes, share what they have seen, and help you remember what the doctor said.2,6
A memory notebook is a good place to keep all of this in one spot. If English is not your first language, ask the office ahead of time for a medical interpreter. Try not to rely on a family member to translate, so they can focus on sharing what they have seen.
Tips for family members
Sometimes the person with memory changes does not see the problem, or does not want to go. That can be part of the illness itself. See when the person doesn't know they are ill.
- Frame the visit as a general checkup, or tie it to another health concern.
- Before the visit, send the doctor a short note or patient-portal message about what you have seen. That way you do not have to list problems in front of your loved one.
- Ask the person to sign a privacy form so the doctor can talk with you.
- Treat the person with respect in the room. Let them answer first, then add what you have noticed.
Questions to ask the doctor
About the cause
About next steps
About daily life
- Is it safe for me to keep driving? See driving and dementia.
- Should someone else help with my medicines or money?
- What can I do now to keep my brain as healthy as possible?
- Who do we call if things get worse suddenly?
After the visit
Write down what you heard, or ask for a printed visit summary. Put follow-up tests and appointments on a calendar.
Waiting for answers can be hard. The Alzheimer's Association 24/7 Helpline at 800-272-3900 can answer questions and help you find local doctors and support.7 If worry turns into hopelessness or thoughts of suicide, call or text 988 any time.
If the answer turns out to be dementia or mild cognitive impairment, our page after the diagnosis: the first 30 days walks you through the next steps. For an overview of the whole process, see getting a dementia diagnosis.
Sources
- Medicare.gov. Yearly "Wellness" visits. Centers for Medicare & Medicaid Services, 2026. Medicare.gov
- Medicare.gov. Cognitive assessment & care plan services. Centers for Medicare & Medicaid Services, 2026. Medicare.gov
- Centers for Medicare & Medicaid Services. Cognitive assessment & care plan services. CMS, 2026. CMS
- Medicare.gov. "Welcome to Medicare" preventive visit. Centers for Medicare & Medicaid Services, 2026. Medicare.gov
- National Institute on Aging. Memory problems, forgetfulness, and aging. NIH. NIA
- Alzheimer's Association. Medical tests for diagnosing Alzheimer's and dementia. Alzheimer's Association. alz.org
- Alzheimer's Association. Visiting your doctor for memory loss. Alzheimer's Association. alz.org
- Alzheimer's Association. Evaluating memory and thinking problems: what to expect. Alzheimer's Association. alz.org
- U.S. Preventive Services Task Force. Cognitive impairment in older adults: screening. USPSTF, 2020. USPSTF
- MedlinePlus. Delirium. National Library of Medicine. MedlinePlus
- Centers for Disease Control and Prevention. Signs and symptoms of stroke. CDC. CDC
Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.