GUIDE requires Original Medicare (Part A and Part B). A Medicare Advantage plan (Part C) doesn't qualify. You can switch to Original Medicare during certain windows each year, and if you do, you can apply for GUIDE again. It's a real coverage decision with tradeoffs, so it's worth getting free, unbiased help before you make it. The tendercare platform is free either way.
Why a Medicare Advantage plan doesn't qualify
GUIDE is a CMS GUIDE Model program built around Original Medicare. Someone enrolled in a Medicare Advantage plan is getting their Medicare benefits through a private plan instead, so they fall outside the program's eligibility rules. This isn't a tendercare rule and it isn't something we can make an exception for. It's how the program is set up.
Most families who apply for GUIDE are on Medicare Advantage. If that's you, you're in good company, and you haven't done anything wrong.
See Am I eligible for the GUIDE Program? for the full requirements.
What's still available to you
All of this is free, and none of it depends on GUIDE.
Find trusted local help. Search Trusted Network members and local providers across 20+ elder care categories, including dementia care, home care, elder law, and aging life management.
Set up a free tenderID. A fridge decal and wallet card that give first responders instant access to medications, conditions, allergies, and who to call.
Get your documents in one place. The Vault holds medical records, legal documents, and the notes everyone in the family keeps asking about.
Know what's next. A tendercare Plan lays out the steps for your situation.
When you can switch to Original Medicare
There are two regular windows each year.
Medicare Open Enrollment, October 15 to December 7. You can switch from a Medicare Advantage plan to Original Medicare during this period. Your plan has to receive the request by December 7, and the change takes effect January 1 of the following year.
Medicare Advantage Open Enrollment, January 1 to March 31. This one is only for people already enrolled in a Medicare Advantage plan. You can drop the plan and return to Original Medicare, and you can also join a separate Medicare drug plan. Coverage starts the first of the month after the plan gets your request.
There are also Special Enrollment Periods for specific life events, like moving to a new address, losing other coverage, or qualifying for Medicaid. If something like that has happened recently, it's worth asking Medicare about.
You can make the change at Medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.
Things to look at before you switch
Switching is a coverage decision, not just a GUIDE decision. A few things families are often surprised by:
Supplemental coverage takes planning. Original Medicare doesn't cap what you pay out of pocket, so many people add a Medicare Supplement (Medigap) policy. Outside of certain protected windows, insurers in most states can ask health questions and turn you down or charge more. If your loved one has dementia, this is the piece to look at first.
Drug coverage is separate. Most Medicare Advantage plans include it. With Original Medicare you'd enroll in a standalone Part D plan.
Extra benefits usually end. Dental, vision, hearing, and transportation benefits that came with the Advantage plan generally don't carry over.
Doctors and costs change. Original Medicare is accepted by most providers nationally, but the monthly and out-of-pocket math looks different.
Every state has a State Health Insurance Assistance Program (SHIP) that gives free, unbiased counseling. They don't sell insurance and they aren't tied to any plan. Find yours at shiphelp.org or call 1-800-MEDICARE.
We'll say this plainly: switching to Original Medicare only to access GUIDE isn't automatically the right move. For some families it opens up real support and money. For others the coverage tradeoffs outweigh it. Talk to SHIP before you decide.
If you switch, check your eligibility again
Once Original Medicare coverage starts, your family may qualify for GUIDE. You can run the eligibility check again then. For eligible families, GUIDE covers care navigation, caregiver education and support, and up to $2,625 per year in respite care, at no cost.
Complete the eligibility check at trytendercare.com/guide. It takes about 2 minutes.