In the past, individuals could only receive Medicaid if they were going into a nursing home for medical care and personal needs assistance. Today, many people who qualify for long-term care prefer to stay in their own homes, even if it means hiring nurses or personal attendants to help with their daily care.
In 1981, the Social Security Act was amended with a compromise for Medicaid-eligible individuals who didn’t want to go into institutions: it allowed states to create Home and Community-Based Services (HCBS) programs to provide in-home care for the elderly or disabled using Medicaid funds.
Who Is Eligible for Medicaid Home Health Care Services?
The first thing you should do if you want to receive HCBS waiver services is to enroll in Medicaid. You will need to apply for benefits and meet all of the requirements necessary so that the government will pay for your home care services.
It’s not easy to meet the state Medicaid eligibility rules, particularly those involving income and resources. The state won’t pay for your nursing care if you have a significant income or assets worth more than a certain threshold. If you are unable to show that you need an institutional level of care or you cannot prove a financial need for benefits, your Medicaid application may be denied. Only careful Medicaid planning with an attorney can prevent this costly setback.
What Kinds of Home Care Are Available in New York?
Each state has the ability to create Home and Community-Based Services programs to benefit seniors or disabled individuals who are eligible for Medicaid. However, not all Medicaid recipients are eligible for HCBS benefits. Individuals will have to be approved for Medicaid and meet certain program requirements in order to have services covered by Medicaid benefits.
New York offers a range of different programs to benefit different groups of people with varying levels of service. All HCBS programs must be proposed to the Centers for Medicare and Medicaid Services (CMS). If the program is approved, the program will receive a 1915(c) waiver allowing it to collect Medicaid funding. In New York, a Medicaid-eligible individual will have to enroll in Managed Long-Term Care (MLTC) before applying for a specific long-term care program.
For example, New York residents may qualify for:
- Home Attendants. The Personal Care Services (PCS) program provides two levels of care. Level 1 provides up to eight hours per week of Housekeeping Services to benefit people with disabilities who need help with cleaning, meal preparation, laundry, maintenance, housekeeping, grocery shopping, and other household tasks. Level 2 provides both Housekeeping and Personal Care Services, including bathing, dressing, grooming, walking, feeding, toileting, medication assistance, preparing meals with dietary restrictions, turning and positioning bedbound individuals, skin care, and other personal needs.
- Nursing Home Transition and Diversion. The NHTD waiver program helps Medicaid-eligible seniors and people with physical disabilities receive comprehensive care services in a community-based setting instead of a nursing home. Participants in this program are able to choose which services they receive, which service providers they work with, and their ultimate goals for their health and welfare. Each participant is empowered to make their own decisions, increasing personal independence and participation in the community or productive activities.
- Developmental Disability Programs. Medicaid pays for many services through the Office for People With Developmental Disabilities, including Home and Community-Based Services (HCBS). These programs include supported employment, residential services, adaptive technologies, community habilitation, day habilitation, residential services, care coordination, and support for children with developmental disabilities.
- Traumatic Brain Injury Programs. A Medicaid beneficiary who has been diagnosed with TBI (or a related life-altering condition) that occurred after the age of 18 and is eligible for a nursing home level of care may receive home care benefits through this TBI program.
Our Elder Law Attorneys Help Get You the Benefits You Need
Too many people make the mistake of giving away assets or selling their houses to qualify for Medicaid benefits. The attorneys at Landskind & Ricaforte Law Group, P.C. can help get you approved for Medicaid without depriving your spouse or family of their home and inheritance. We can create an asset protection trust to preserve your valuables for your heirs, file your application or appeal, and ensure you take advantage of the lookback period deadline. Simply contact us today through our online form to get help.