Medicare's decision to offer limited coverage, which will not take effect for at least three months, could lead private insurers to begin covering specialized PET scans for Alzheimer's, which can cost $1,500.
Alzheimer's sometimes is indicated by symptoms, but a definite diagnosis can be made only after death. The test Medicare will pay for can detect the presence of plaques in the living brain, which are evidence of the disease. Medicare announced the change Tuesday.
At first, the government intends to cover "patients with progressive symptoms of dementia, but for whom a diagnosis remains unclear despite a thorough standard medical evaluation," said Sean Tunis, the chief medical officer for the federal Centers for Medicare and Medicaid Services.
In addition, some Medicare patients in clinical trials for people with unexpected memory loss or early dementia would have PET scans paid for as a way to explore how widely the scans could be used.
Researchers and doctors believe that early detection of Alzheimer's, leading to early treatment with medicines, can help slow its progression.
With the support of the Alzheimer's Association, Medicare rejected an earlier proposal to cover PET scans widely, saying their usefulness has not yet been proved.