What Are the Differences Between Medicaid and the Medicaid Waiver?
At Independence Care we get asked this question often.
We understand that you and your family want to take advantage of any program that can offer financial assistance. And, that the options, rules, and benefits can be difficult to understand. The administration staff at Independence Care has years of experience helping families receive the benefits they are entitled to. Let us walk you through the different options to help you decide what is the best opportunity for you and your family as well as assist in filing any necessary paperwork.
What is Medicaid?
- Health insurance designed for low-income persons with limited financial resources
- Has strict income and asset limits
- Can be used for some out-of-pocket costs (premiums and co-payments)
What is the Medicaid Waiver?
- Federally approved but run by the state so each state’s benefits may be different
- Enrolled individuals reside at home or in the “community”
- Also referred to as 1915 (c) waivers, HCBS waivers, waiver services, waiver programs and some state-specific names
Important Differences between Medicaid and Medicaid Waivers
Nursing home Medicaid is an “entitlement program”. This means the recipient is automatically entitled to receive the benefits if they qualify by meeting the eligibility requirements. On the other hand, Medicaid waivers are limited and even those who qualify may not receive the benefits or enroll in the program. This means that even though one meets all the eligibility requirements, they may be put on a waiting list. The reasons being that if the enrollment cap is reached, only specific areas are available to the Medicaid waiver or certain medical diagnoses, such as Alzheimer’s are eligible.
We have experience in both the Pennsylvania Medicaid waiver programs and the New Hampshire Medicaid waiver programs. Contact us to see how we can help you and your family navigate these programs that may seem confusing but offer a wealth of benefits.
Private Pay for Home Health Care in Pittsburgh, PA, Philadelphia, PA, Bethel Park, PA, Concord, NH, Wexford, PA, and the Surrounding Areas
Private pay for home care, elder care, and home care assistance means the services are covered by existing savings or assets. Private pay comes with many benefits including:
- Not limited to certain services
- Not requiring doctor’s approval
- Immediately available
- No eligibility requirements
- Freedom to use on short-term or long-term basis
- Customize to the type of care needed
Many families use private pay to ease the burden of taking care of a loved one and to ensure their loved one is in a safe and comfortable environment. Private pay home health care is often paid for by liquidating assets of the patient including second homes, vehicles, stocks, savings or unneeded household items. Other families may feel the benefits of home health care are worth using their own contributions.
Independence Care Assistance with Navigating Payment Options for Home Health Care
Our staff is experienced with working through the different payment options for senior home care assistance and caregivers for seniors. We know the ways to apply for financial assistance as well as how to maximize the resources you have. If you have limited resources available, we can help create the schedule and list of duties that will provide the elder care and home health aide services your family needs.
We work with all Medicaid Health Plans, as well as Private Pay and Managed Care Organizations (MCO’s) and can help families find the assistance they need throughout Pittsburgh, PA, Philadelphia, PA, Bethel Park, PA, Concord, NH, Wexford, PA, and the surrounding areas.