My father is 66 and was diagnosed with Alzheimer's while traveling in China. He came back to NYC and I am trying to get him Medicaid and Medicare Part B. From what I heard, since he missed the deadline last year for Medicare Part B, he has to apply for it in January and it doesn't take effect until June or July. While applying for Medicaid, his income is too high and is eligible for Spend Down or Pay In Program. Does anyone have experience with this and can help me with the following questions? Do I have to apply every month for spend down or pay in? Is the start date for every month, the 1st of the month? Do I have to go in person or can I do it through mail, phone or the web? How long can I participate in each program and can I switch whenever I want? if the bills do not go over the excess income amount, what happens? do I have to go in person to deliver the bills or mail them? For the pay in program, how is the money taken? As of now, my father can take care of himself but does not go out. How do I get him out to see a doctor to get diagnosed in the States? In the future, I might consider Managed Long Term Care, home attendant, nursing home, personal care service, etc. Can anyone tell me also how that works? Thanks for all your help.
Medicare is AGE based eligibility and you qualify at age 62 I believe.
Everyone gets it in the USA- period MediCAID is a poverty/safety net based program. It is Federal & State funded and based on a family/individual's income level. An elderly person must be basically in poverty. Each state has a different income they consider poverty but say in Ohio it's like I think $1900 a month for an individual. If you fall below that you can get Medicaid services.
'Spend down' means- spend all your money and deplete your assets then we'll(Medicaid) will help you -once you're basically destitute. If he has assets like a house and savings and 401k etc. that has to be spent down before taking Medicaid services. If it's hidden/etc -the state will come back for it when they find out you had it. State Medicaid's have entire divisions that that's all they do- collections. They also do a 5 year look-back for people trying to hide assets and will collect on that too if they identify it.
Each state Medicaid Plan is different and has different services available
It seems you are in NY so you'd have to speak to/research online with those Medicaid folks. Usually your resident COUNTY acts as the intake for Medicaid. eligibility so they can give you the numbers plain and simple(maybe). Good luck-it is a situation where it's best to either be dirt poor or very wealthy and able to pay $7k/month at a nice alzheimers facility. The goal of the govt. programs is to keep people in their home as long as possible. And Alzheimers/Dementia care is not as fully developed in the state/federal plans so coverage and care isn't built around that health problem- it's more of a physical disability - and Medicaid /Medicare are 95% focused on physical issues. The mental health arena has up til recently been really subjugated. Persisstent problems in our society like homelessness, addictions and people killing innocent people for no reason-have caused policy makers to take a 2nd look at preventative help for mentally disturbed individuals and policies are shifting back to give mental health the respect it deserves- so hopefully dementia care/services will be better covered. it's a bit of a gap right now- I know my mother is in early stages..and there's zero 'coverage' to assist her. it's on the family for now.
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