We plan on in home care as long as we can, but I've learned some assisted living facilities won't let dementia patients in on their own. Since the cost for memory care is so high, how do you plan for the spend down? Do you apply first or go through your money first? Can you get spousal impoverishment after you get mede-cal. or at the same time? It's all very confusing. Thanks for your input.
Don't assume Medi-Cal will cover a memory care facility -- Medicaid doesn't in most states. California has an Assisted Living Waiver, but it's only available in certain counties and participating facilities, and there's a waiting list. It doesn't cover room and board. The look-back period is 2-1/2 years in CA so it's important how you manage your money so that you don't accidentally delay or disqualify yourself.
A good resource is California Advocates for Nursing Home Reform (CANHR.org). They have information on Medi-Cal eligibility, spousal impoverishment, and attorney referrals.
Start looking into which facilities near you actually accept Medi-Cal or participate in the Assisted Living Waiver. It's better to know your options now than to be trying to figure everything out during a crisis.