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5 Things Caregivers Need to Know About Medicaid-Sponsored Home Care

By Benjamin Lamm

(Page 1 of 2)

The home care industry is booming, in part because of the sheer size of the current generation of retirees.  Also, because many baby boomers, famous for “doing things their own way,”’ are choosing to move away from traditional nursing home care and considering other senior living options, like aging in place, memory care or community living.

The Bureau of Labor Statistics foresees a 70 percent increase in the amount of people who will need in-home care over the next 10 years. Unfortunately, many people are not prepared to pay for their own in-home care, which means they may find themselves dependent upon assistance programs.

Does Medicaid Pay for In-Home Care?

The type and amount of coverage varies by state, and the eligibility guidelines are subject to frequent change. It is often advisable to reach out to a Medicaid planning expert or educate oneself thoroughly so one can gain access to the Medicaid-sponsored care one requires.

The short answer, though, is that every state provides some form of care options for the elderly or handicapped. Generally, Medicaid doesn't technically fund in-home care unless there is an express medical condition. Instead, waivers of Medicaid rules are applied, which in turn provide the funding for these home and community based services.

What In-Home Services Does Medicaid Offer?

Once again, specific services vary by state, but Medicaid in-home services are generally very limited. They fall under the heading of “Home Health Services,” and they are only allowed for direct medical care – typically for a short-term illness or recovery period. There is a limit on the amount of hours of care allowed over a set period of time, or limitations may be upon the amount of care visits allowed per week. For example, you may be allowed two physical therapy visits weekly, or only 120 hours of nursing visits over a six-month period.

What Exactly Are Home and Community-Based Services programs?

This brings you back to the home and community-based programs mentioned previously. The waivers issued for these services can give you access to in-home health and nursing care, physical therapy, and medical assistive devices and transportation. They can also help with ongoing care needs, such as adult daily living services, meal preparation or delivery, and adult day care services.

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