Medicare Set to Cover Advanced Alzheimer’s Screening by 2028: What the ASAP Act Means for Seniors

The proposed Alzheimer’s Screening and Prevention Act of 2025, or the ASAP Act, is straightforward: it mandates that Medicare must cover early detection screening tests for Alzheimer’s disease and related dementias. This isn't just about covering basic cognitive exams; we’re talking about high-tech diagnostics like genomic sequencing blood tests, specialized blood analysis, and medical imaging. This expanded coverage kicks in starting January 1, 2028, and it’s a big deal for the millions of people on Medicare and their families.

The Fine Print on Future Diagnostics

Under this bill, a covered test has to be cleared, classified, or approved by the FDA. The bill specifically lists advanced tests, including 'genomic sequencing blood or blood product tests.' Think of it as using cutting-edge science to spot issues before symptoms even become noticeable. For a 68-year-old managing their health, this means Medicare could soon pay for a blood test that might identify risk factors years earlier than current methods allow. The bill also amends the Social Security Act to ensure these tests are added to the list of covered medical services and paid for under the clinical laboratory fee schedule.

The Secretary’s Discretion: Who Decides What’s Equivalent?

While the bill names specific tests, it also throws a wide-open door to the Secretary of Health and Human Services. The Secretary can determine that other tests—like protein expression analysis or whole exome sequencing—are covered if they provide 'comparable results' to the high-tech tests listed. This is where things get a little squishy. Granting the Secretary that much authority to define what counts as an 'equivalent test' is necessary to keep up with fast-moving medical science, but it also gives the administration a lot of power to decide which specific companies and technologies get the green light for Medicare payment. It’s a necessary flexibility, but one that requires careful oversight to ensure the decisions are based purely on medical evidence.

The Real-World Impact on Your Wallet and Care

For Medicare beneficiaries, the benefit is huge: access to potentially life-changing early detection without the massive out-of-pocket costs that cutting-edge diagnostics usually carry. Earlier detection means earlier intervention, which could significantly impact the quality of life for people facing this disease. However, there’s a cost consideration. Mandating coverage for these advanced, and likely expensive, tests—especially genomic sequencing and advanced imaging—will add a significant financial burden to the Medicare program starting in 2028. While this is a massive win for patient care and the diagnostic industry, taxpayers and current Medicare participants need to be aware that this expansion will put upward pressure on overall Medicare expenditures. The bill promises better health outcomes, but it comes with a built-in price tag for the federal budget.