When your loved one can no longer take care of themselves, caregiving at home becomes a good option. Medicaid home care can become a lifeline for your family. However, you don't want to get into the program without being aware of the long waiting lists and state-specific rules.
Per the reports from Open Mind, Medicaid covers nearly 70% of all home care expenses in the U.S. This statistic shows that Medicaid pays for most of the home care in the country.
While it plays a big role in funding home care, most families enter the program blindsided by its difficulties. Knowing how the Medicaid care basics will save you a lot of trouble as you search for care for your loved one.
What Is Medicaid Home Care?
Medicaid home care, also known as "home- and community-based services" (HCBS), is a program that ensures older adults and people with disabilities who have low income and assets get care. All states offer Medicaid home care through:
- 1915(c) waivers
- 1115 waivers
- The Community First Choice option
- Personal care services as a state plan benefit
As a family, you can opt for the Medicaid program to ensure your loved one gets assistance with activities of daily living, such as eating, bathing, and dressing. They can also get help with instrumental activities like preparing meals, managing medications, and light housekeeping.
What Are the Three Main Strengths of a Caregiver?
If you're a caregiver, you offer assistance as well as companionship and support. Here are some caregiver tips and strengths you should have to be effective:
Empathy
You can show empathy by understanding and sharing the feelings of another person. As an empathetic caregiver, you can:
- Actively listen to the person you're caring for
- Validate their feelings
- Understand them during challenging moments
If you're empathetic while on duty, you can create a meaningful and fulfilling experience for you and your client.
Patience
If you're working at Medicaid home care Philadelphia PA, you need to be patient. Patience allows you to stay calm and respectful in all situations.
Adaptability
Caregiving can be unpredictable. The needs of your client can change over time, requiring you to be flexible in your approach. You should be able to face challenges with resourcefulness and resilience.
Why Is It Important for Families to Be Involved in Their Care?
Family involvement in caregiving plays an important role in enhancing outcomes of home care. Below is a family caregiver guide that explains the benefits:
- Improves comfort
- Act as an advocate for your loved one's care
- Fosters your loved one's emotional stability and sense of security
Clear and open communication between families and caregivers is important. You can take part in decision-making and voice your loved one's concerns.
What Caregivers and Families Wish They Knew About Medicaid Home Care Before Starting
Navigating Medicaid applications for home care isn't easy. Here is what you can expect;
Strict Eligibility Rules
Medicaid's eligibility requirements can catch you off guard. Some requirements include:
- Age/disability: Must be 65+ or have a qualifying disability
- Income limit: Maximum $2,901/month (300% of SSI) in most states
- Asset limit: Cannot exceed $2,000 in countable assets per person
- Functional need: Must require help with activities of daily living
- State residency: Must be a resident of the state where applying
These requirements determine whether your loved one will get help or not. A lot of families discover too late that issues like a joint account with you and your aging parents can increase the asset limit, making your loved one ineligible for care.
Long Wait Times
KFF estimates that nearly 2.5 million people get their Medicaid home care through waivers. Since states can cap these waivers, you may end up stuck on waiting lists.
If your loved one is in great need of care, being told to wait can be devastating. To stay on the right track, start applying for the home care process as soon as possible, even before you think you'll need it.
Dealing With Extensive Documentation
Since Medicaid is a public program with capped budgets and strict eligibility, every hour of care provided must be accurately tracked. You need to stay up to date with documentation that shows your loved one still qualifies for the service that Medicaid pays for.
The documentation is the ongoing proof needed to maintain that eligibility and get paid. If you don't have it, you risk facing payment denials.
Family Caregivers Can Get Paid
Self-directed programs in many states allow family members acting as caregivers to receive payment. This compensation can help you reduce work hours so you can offer quality care.
Frequently Asked Questions
What Is the Biggest Problem With Medicaid?
One challenge facing Medicaid is eligibility and state oversight. Each state sets its own eligibility requirements. However, 37 states allow private insurers who withhold important patient data to manage the care.
This situation makes the state unable to properly monitor enrollment or health trends. Without good data, the state can't efficiently control spending, improve care, or prove the program's value to budget officials. It may be the reason for Medicaid budget cuts.
What Are Your Goals as a Caregiver?
If you're a caregiver, you need to have realistic goals. Your goals will depend on your client's needs. Assess their needs and figure out if you need to ensure their emotional well-being or physical comfort.
Once you make clear goals, you can break them into small, manageable tasks. It will make your work easier.
What Should a Caregiver Not Do?
As a caregiver, you should not offer medical care. Make sure you only provide nonmedical assistance, such as cooking or light housekeeping. You may perform some medical tasks, like administering medications.
Additionally, you shouldn't make home renovations. If you notice something amiss in the home, inform the family.
Stay Up to Date With Medicaid Home Care Information
Dealing with the Medicaid home care process can be challenging. From the strict eligibility requirements to long wait lists, you need to know what to expect so that you can get started on the right foot. You can also seek out professional guidance to make the process hassle-free.
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