How do you know what Medicare plan a spouse should choose if you're not sure if they're going into an ALF?

Your local Office of Aging maybe able to help. I live in NJ. The ALs near me may take Medicaid after 2 yrs private pay but not before.

You should get a trained professional, e.g. an insurance agent for this question.

Disgustedtoo you are talking about Medicare Advantage Plans not Medicare Supplement. Advantage plans are regional and come in PPO, HMO and PFFS and limit you to a certain area for coverage and certain providers who participate in the plan. They are also generally cheaper than Supplement plans. Medicare Supplements do just that, Pay after Medicare pays. They only cover a skilled nursing visit after a minimum of a 3 day hospital stay and only for Rehab treatment. They do not cover Assisted living. You are only limited on what Dr you can see by if the MD accepts Medicare. If they don't accept Medicare then the insurance won't cover that provider.

I hope you an understand that. Approval not provable.

Compasioaire- go ahead and apply. Get on the waiting list. If something happens then your LO will go into a hospital and then a skilled nursing facility and will stay there until the waiver comes through. My inlaws have been in skilled nursing since las February awaiting provable for waiver. Because of their financial situation they were quickly approved for coverage at NH until their waiver comes through. Then they will be moved into memory care. They are in riverside county but I don't think it matters which county- it's all California for waiting list. They recently told us it will probably sometime next year. My mil and FIL hate it in NH but they have no choice. They can not care for themselves and they are volitile in personality so they can not live with us in our small house. Plus he is a huge man and I'm a small woman.

Unfortunately the best way to determine what Medicare plan to select is to explore ALL the options available to you. The Medicare gov page can help with this - given some information from you it will provide a list of options, then you must pick through details and weigh the differences.

My options are limited due to being in a more "rural" area, however several are HMO and those do not suit my needs. For this year I chose the PPO (preferred provider option) as in checking what hospitals, doctors and other services were covered, this one had them all. The others did not. Of course, that plan is no longer available for next year, so I have to choose next best, which (no surprise) costs more - but it still gives me access to the doctors, etc that I use.

Once you enter zip, I believe next is a list of all medications (I skip this as I am not taking anything, but you can also skip it - if you do enter it, that list can be "saved" for future inquiries). It is not an easy site to navigate, so if you are not very computer savvy, you can find resources to call and ask for help. Take lots of notes, ask lots of questions (co-pays, coverage, deductibles, maximums, what medications are covered and how much).

As the first person responded noted, choosing a Medicare plan really has nothing to do with AL, whether traditional AL or Memory Care, as those are NOT covered. The concerns with which plan to choose relate to what ongoing or future medical conditions and/or issues that you anticipate and whether your current medical providers are In-Network or not.

Most Assisted Living Waivers are state-run plans that come out of Medicaid money. Since they are funded by the state often they are restricted by state budgets and when the money runs out they have waitlists. I would contact MediCal and discuss your options with the local Area Agency on Aging for your county. Try to get on the waitlist. If you have any extra funds to pay for assisted living for a time those already in assisted living may get priority for waivers to stay there over those currently living at home (depends on the state).

But...how do you apply for Assisted Living Waiver in Orange County, CA? They are out of money and the waiting list is nearly 1 year? Options?

Medicare does not pay for assisted living. It doesn't matter what plan you choose- AL is out of pocket. Medicare will pay for a skilled nursing facility for a fixed amount of time should a Dr. order it for rehab after a fall or surgery ,etc. If you are indigent you may qualify for medicade which will help pay for AL if you qualify.