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.