Finding quality at-home care for the senior in your life can be stressful. Trying to unriddle Medicaid home health care guidelines to ensure they can pay for that care can weigh heavily on your already crowded shoulders. What does Medicaid cover? Is your loved one over the income level? What if they’re under age 65?
The best Medicaid-approved home health agencies should not only provide patient-centered services but also remove any coverage confusion that keeps your loved one from getting care. But having a better understanding of what Medicaid does – and does not – cover before that first appointment can go a long way in getting your questions answered.
Services beyond skilled nursing for seniors
If a senior is on Medicare, the program covers in-home skilled nursing care, including wound care, injections, health maintenance, and therapy. However, in many cases, a patient recovering from an injury or illness needs more than a nurse – they need someone who can help with dressing, cleaning, and transportation. Unfortunately, that’s where Medicare reimbursements stop; mom or dad is left to pay for necessary “non-medical” care out-of-pocket or through private insurance.5
In Missouri, residents who are 63 years of age or older and have a monthly income at or below $1,311 as of January 2018 may be eligible for MO HealthNet, the state’s form of Medicaid. MO HealthNet helps cover medical costs, including copayments and deductibles, that remain after Medicare reimbursements. But even more important to those facing a choice between in-home and nursing care is the fact that Medicaid pays for the personal care needs that keep a senior in their home longer.
Medicaid home health care – what is covered?
According to MO HealthNet, if an individual on Medicaid is authorized by the State Department of Health and Seniors Services to receive care at a skilled nursing facility, but would prefer to remain in their home, they can apply for an Aged and Disabled Waiver if they are over age 63. The waiver not only allows medical care and therapy to continue at their residence but allows the addition of in-home support services, including:
- Cleaning and laundry
- Delivery of meals or meal preparation
- Personal services, such as bathing, dressing and personal hygiene
- Transportation to and from doctor appointments
- Medical equipment
- Home modifications, such as installing a wheelchair ramp
The key to remember that a number of financial conditions, such as investments, a marriage, and even an extra car at home can alter one’s eligibility for Medicaid. In addition, if your loved one moves, their coverage will not necessarily come with them, because unlike Medicare which is a federal program, Medicaid varies from state to state. For additional information, visit the MO HealthNet home and community-based programs page.
Helping the St. Louis region with Medicaid eligibility and home care questions
Envision Health Partners, one of the state’s top Medicaid approved home health agencies, understands the complexities of Missouri-based insurance and the issues that can keep seniors from getting the care they need. Before we step inside your loved one’s home to deliver care, we help them determine their eligibility, whether that’s through Medicare, Medicaid or both, and work to ensure that the services we deliver fit their financial guidelines. To learn more about Medicaid home health care programs, contact us today for a free assessment.
Need help talking with your parent or other family members?
Feel free to contact us today for a free in-home assessment as we can provide helpful suggestions that will make this difficult conversation a little easier.